title: HbA1c 3 months after diagnosis predicts premature mortality in patients with new onset type 2 diabetes.
abstract: OBJECTIVE
  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 (P < 0.005) Age at diagnosis was the strongest predictor of mortality (P < 0.001) but HbA(1c) at 3 months after diagnosis (P < 0.001), systolic (P < 0.001) and diastolic (P = 0.05) blood pressure, smoking status (P < 0.001) and gender (P = 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 HbA(1c) 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.
authors.affiliation: Bournemouth Diabetes and Endocrine Centre and Centre of Postgraduate Medical Research and Education, Bournemouth University, UK.
authors.forename: D
authors.initials: D
authors.lastname: Kerr
authors.forename: H
authors.initials: H
authors.lastname: Partridge
authors.forename: J
authors.initials: J
authors.lastname: Knott
authors.forename: P W
authors.initials: PW
authors.lastname: Thomas
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature; D011237:Predictive Value of Tests; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin