HbA1c variability is associated with higher rates of adverse outcomes such as microvascular and macrovascular complications, cognitive decline, amputations, and mortality. A recent study conducted by a research group from Israel which got published in ‘Diabetes Metabolism Research and Reviews’ reports that HbA1c variability and trends in different ages are strongly associated with mortality risk.

     The study included 293,314 patients aged 35 to 89 years with diabetes listed at least four times in the Israeli National Diabetes Registry. Using machine learning techniques patients were classified into clusters according to their HbA1c trend (increasing, stable, decreasing). Mortality risk was calculated in subgroups defined by age (35–54, 55–69, 70–89 years) and last HbA1c (≤7% and >7%) at end of the observation period. The results from the study at the end of the observation period revealed that patients with a decreasing vs. stable HbA1c trend had a greater mortality risk and this association persisted in all age groups in patients with HbA1c > 7% and patients with an increasing versus stable HbA1c trend had a greater mortality risk only in the elderly group (>70).

According to the researchers, the study signifies the importance of maintaining glycaemic stability throughout the years and encourages physicians to consider the long-standing glycaemic burden of their patients when evaluating their prognosis.