A1C Variability Predicts All-Cause Mortality in Patients With Type 2 Diabetes

March 26, 2018. A total of 15,733 patients with type 2 diabetes (T2D) enrolled in the 2006-2008 Renal Insufficiency and Cardiovascular Events Italian multicenter study. A1C measures and vital status data from 8,252 of these patients were used to evaluate the relationship between A1C variability vs A1C average and all-cause mortality. A total of 3 to 5 A1C values were used to calculate A1C-MEAN (average) and measures of A1C variability (intra-individual standard deviation [A1C-SD], SD adjusted for number of A1C assessments [A1C-AdjSD], and coefficient of variation [A1C-CV]). After adjusting for confounders and/or each other measure, mortality increased with quartiles of all A1C variability measures but not with A1C-MEAN. Regardless of whether A1C-MEAN was above or below the median, mortality risk was higher for A1C-SD above the median and lower for A1C-SD below the median. This study demonstrated that A1C variability is a strong and independent predictor of mortality in patients with T2D and indicates that it is a stronger predictor of mortality than average A1C. Read the abstract here.