Type 2 diabetes mellitus and higher glycated hemoglobin (HbA1c) levels were associated with the risk of cardiovascular diseases and deaths, according to a study led by Dr. Kuo-Liong Chien with his master student, Ms. Yun-Yu Chen, at the National Taiwan University.  This study has been published online on April 13 in PLoS One.

[Photo: Dr. Shih-Ann Chen, Ms. Yun-Yu Chen, Dr. Yenn-Jiang Lin, and Dr. Kuo-Liong Chien]

“Optimal diabetes control is important to prevent further microvascular and macrovascular complications,” said Miss Chen, the first author of the paper and a graduate of Master of Public Health Program, now a faculty in the Cardiovascular Research Center, Taipei Veterans General Hospital, headed by Professor Shih-Ann Chen.  “However, evidence of the role of baseline HbA1c on macrovascular complications was scanty in Taiwan.  This study is the first study representing real-world epidemiologic data in large numbers for HbA1c levels and long-term cardiovascular outcomes from the nation-wide representative cohort from Taiwan.”

By analyzing 5,277 participants during a median of 10 years’ follow-up duration, this study found that diabetes led to higher HbA1c levels were associated with future risks of cardiovascular events and all-cause death, and the risk of ischemic stroke increased by 1 percent increment of HbA1c regardless of diabetes diagnosis. In addition, HbA1c levels ≥7.5% (58.5 mmol/mol) increased future risks of ischemic stroke, coronary heart disease, and all-cause death compared with those having HbA1c levels <5.5% (36.5 mmol/mol), with a dose-response relationship.” said Miss Yun-Yu Chen. Miss Chen conducted the study through integrating Taiwan’s Hypertensive, Hyperglycemia, Hyperlipidemia Survey (Triple High Survey) and Taiwan’s National Health Insurance Research Database (NHIRD) to analyze the primary biomarker data, clinical measures and secondary health dataset with validated outcomes together.

Professor Chien and his colleagues concluded that elevated HbA1C levels were associated with increased risks of cardiovascular disease and death, the suboptimal glycemic control with HbA1c level was strongly associated with increased risks of cardiovascular disease and all-cause death.