Objective: To evaluate whether the early intensive glycemic control is responsible for development of diabetic complications as well as to determine early target HbA1c achievement affects long-term durable glycemic control.
Methods: Of 194 patients with newly diagnosed type 2 diabetes between Jan 2011 and Mar 2013 in the original cohort, 145 were followed-up for > 6 years. Glycemic durability group was defined as the maintenance of optimal glycemic control (HbA1c < 7.0%) without an intensification of glucose-lowering treatment regimens during first 2-year. Microvascular and macrovascular complications were assessed by multiple logistic regression analysis.
Results: During a median follow-up of 6.53 (range 5-9) years, 66 microvascular and 14 macrovascular events occurred. Risk of composite microvascular complications (OR; 4.55, 95% CI; 1.74-11.91) and composite macrovascular complications (OR; 5.57, 95% CI; 0.84-36.78) were higher in the non-durability group than in the durability group. In addition, early achievement to target HbA1c (<3 months) was associated with maintenance of 6-year durable glycemic control (HR; 3.56. 95% CI; 1.14-11.16), and lower risk of microvascular complications (HR; 0.46, 95% CI; 0.26-0.82) compared to late achievement (> 6 months).
Conclusion: This real-world database analysis showed that early intensive glycemic control was associated with a sustained effect on glycemic durability as well as significant reduction in the risk of microvascular complications.
N. Kim: None. S. Kim: None. H. Jang: None. K. Kim: None. H. Kim: None.