Elderly diabetics with poor glycaemic control suffer from high cardiovascular risk

Poor glycaemic control aggravates the risk of cardiovascular events among older adults with diabetes mellitus, a recent Japan study has found.

Drawing from anonymized health data, the researchers looked at glycated haemoglobin (HbA1c) levels in 3,946 elderly adults (mean age 72.2 years, 53.2 percent men) approximately 10 months after initially being diagnosed with diabetes mellitus. The primary study outcome was a composite of cardiovascular events, defined as hospitalization for stroke, angina pectoris, heart failure, or myocardial infarction, along with coronary revascularization.

At the index date, the median HbA1c level was 6.60 percent. Participants were then divided into quartiles according to their HbA1c concentrations, with value ranges of <6.3 percent, 6.3 to <6.6 percent, 6.6 to 7.2 percent, and ≥7.2 percent for groups 1–4, respectively.

The composite cardiovascular endpoint occurred in 142 patients. Group 4 saw the highest incidence rate at 24.5 per 1,000 person-years, while groups 1–3 had similar rates, ranging from 10.1–13.2 per 1,000 person-years.

Compared with group 1, the composite outcome occurred significantly more frequently in group 4 (p<0.001). In turn, this corresponded with a significantly elevated risk estimate for group 4, as calculated by multivariate Cox proportional hazards models (hazard ratio [HR], 1.948, 95 percent confidence interval [CI], 1.252–3.031; p=0.003).

Notably, each component of the primary composite outcome likewise occurred more frequently in group 4, while incidence rates in groups 1–3 were comparable.