HbA1c 3 months after diagnosis predicts premature mortality in patients with new onset type 2 diabetes


Helen Partridge, Bournemouth Diabetes and Endocrine Centre, Royal Bournemouth Hospital NHS Foundation Trust, Bournemouth, United Kingdom BH7 7DW. E-mail: Helen.partridge@rbch.nhs.uk


Diabet. Med. 28, 1520–1524 (2011)


Aims  To determine 5-year mortality rates, following the diagnosis of Type 2 diabetes, in a large local cohort of individuals with new onset of Type 2 diabetes seen within a few weeks of diagnosis in a single, community-based education programme.

Methods  We reviewed referrals for people with Type 2 diabetes to our service over 5 years from 1999 to 2003 and determined, via regression analysis, which factors contributed significantly to mortality rates up to the end of 2007.

Results  A total of 3781 new referrals were reviewed with an approximate doubling of referral rates over 5 years (546 in 1999–997 in 2003). Although the number of people developing the condition has increased, mortality rates over the 5 years from diagnosis has fallen from 11% in 1999–9% in 2003 (< 0.005) Age at diagnosis was the strongest predictor of mortality (< 0.001) but HbA1c at 3 months after diagnosis (< 0.001), systolic (< 0.001) and diastolic (= 0.05) blood pressure, smoking status (< 0.001) and gender (= 0.04) were also significant predictors.

Conclusions  Our retrospective analysis adds weight to evidence suggesting that referral rates for people with Type 2 diabetes are increasing rapidly and that mortality rates are reducing but that the reasons for this are multifactorial. In addition to blood pressure, smoking and gender, the HbA1c achieved 3 months after the initial diagnosis also appears to predict subsequent mortality. It may be appropriate to consider early and intensive intervention for individuals with new onset type 2 diabetes.