Kaiser Permanente Southern California, Pasadena, CA, USA.
Kaiser Permanente Northwest, Portland, OR, USA.
J Diabetes Complications. 2020 Aug;34(8):107607. doi: 10.1016/j.jdiacomp.2020.107607. Epub 2020 Apr 27.
To estimate time in suboptimal glycemic control among patients with incident type 2 diabetes (T2D) over 10 years.
We calculated percent of time in suboptimal glycemic control using three A1C thresholds (8%, 7.5%, 7%) following T2D diagnosis. Stratified analyses were conducted based on age and A1C levels at T2D diagnosis.
We identified 28,315 patients with incident T2D. Percent of time in suboptimal glycemic control increased with T2D duration. Mean percent time in suboptimal A1C control in the first 2 years following diagnosis was 30%, 34% and 40% for the 8%, 7.5%, and 7% thresholds, respectively. In the 6-10 years following T2D diagnosis, the percent time in suboptimal A1C control increased to 39%, 48% and 61%, for the 8%, 7.5%, and 7% thresholds, respectively. Time in suboptimal glycemic control was longer among younger patients aged 20-44 versus ≥65 years and those with higher A1C (>8%) versus lower A1C (<7%) at diagnosis.
Over 10 years following diagnosis, T2D patients spent one-third to over one-half of their time in suboptimal glycemic control. Reducing time spent above desired A1C targets could lower risk of microvascular and macrovascular complications.
估计新诊断 2 型糖尿病（T2D）患者在 10 年内处于血糖控制不佳状态的时间比例。
我们使用三个糖化血红蛋白（A1C）阈值（8%、7.5%和 7%）计算了 T2D 诊断后血糖控制不佳的时间比例。根据 T2D 诊断时的年龄和 A1C 水平进行了分层分析。
我们确定了 28315 例新诊断的 T2D 患者。血糖控制不佳的时间比例随着 T2D 持续时间的增加而增加。诊断后前 2 年内，血糖控制不佳的平均 A1C 时间比例分别为 8%、7.5%和 7%阈值的 30%、34%和 40%。在 T2D 诊断后 6-10 年内，血糖控制不佳的 A1C 时间比例分别增加至 8%、7.5%和 7%阈值的 39%、48%和 61%。在诊断时年龄较小（20-44 岁）的患者与年龄较大（≥65 岁）的患者和 A1C 较高（>8%）的患者与 A1C 较低（<7%）的患者相比，血糖控制不佳的时间更长。
在诊断后 10 年内，T2D 患者有三分之一至一半以上的时间处于血糖控制不佳的状态。减少高于理想 A1C 目标的时间可能会降低微血管和大血管并发症的风险。
