{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:26:48Z","timestamp":1761895608377},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,3,13]],"date-time":"2013-03-13T00:00:00Z","timestamp":1363132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To explore the association of HbA<jats:sub>1c<\/jats:sub> and educational level with risk of cardiovascular events and mortality in patients with Type\u00a02 diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 32\u00a0871 patients with Type\u00a02 diabetes aged 35\u00a0years and older identified by extracting data from electronic patient records for all patients who had a diagnosis of Type\u00a02 diabetes and had glucose\u2010lowering agents prescribed between 1999 and 2009 at 84 primary care centres in Sweden. Associations of mean HbA<jats:sub>1c<\/jats:sub> levels and educational level with risks of cardiovascular events and all\u2010cause mortality were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The associations of HbA<jats:sub>1c<\/jats:sub> with risk of all\u2010cause and cardiovascular mortality were J\u2010shaped, with the lowest risk observed for cardiovascular mortality at an HbA<jats:sub>1c<\/jats:sub> level of 51\u00a0mmol\/mol (6.8%) for subjects on oral agents and 56\u00a0mmol\/mol (7.3%) in insulin\u2010treated patients. The lowest risk observed for all\u2010cause mortality was at an HbA<jats:sub>1c<\/jats:sub> level of 51\u00a0mmol\/mol (6.8%) for subjects on oral agents and 56\u00a0mmol\/mol (7.3%) in insulin\u2010treated patients. There was an increased risk for cardiovascular death [hazard ratio\u00a01.6 (1.2\u20132.1), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.0008] at the lowest HbA<jats:sub>1c<\/jats:sub> decile for subjects in the low education category. For subjects with higher education there was no evident J curve for cardiovascular death [hazard ratio\u00a01.2 (0.8\u20131.6), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.3873].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results lend support to the recent American Diabetes Association\/ European Association for the Study of Diabetes position statement that emphasizes the importance of additional factors, including the propensity for hypoglycaemia, which should influence HbA<jats:sub>1c<\/jats:sub> targets and treatment choices for individual patients.<\/jats:p><jats:p>(Clinical Trials Registry No; NCT 01121315)<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.12145","type":"journal-article","created":{"date-parts":[[2013,1,28]],"date-time":"2013-01-28T09:00:01Z","timestamp":1359363601000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Associations of HbA<sub>1c<\/sub> and educational level with risk of cardiovascular events in 32\u00a0871 drug\u2010treated patients with Type\u00a02 diabetes: a cohort study in primary care"],"prefix":"10.1111","volume":"30","author":[{"given":"C. J.","family":"\u00d6stgren","sequence":"first","affiliation":[{"name":"Department of Medical and Health Sciences Link\u00f6ping University Link\u00f6ping"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Sundstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Uppsala University Uppsala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Svennblad","sequence":"additional","affiliation":[{"name":"Uppsala Clinical Research Center Uppsala University Uppsala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Lohm","sequence":"additional","affiliation":[{"name":"AstraZeneca Nordic S\u00f6dert\u00e4lje"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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