Determinants of HbA1c variability among type 2 diabetes mellitus patients in Malaysian primary care setting

Abstract Diabetes complications were shown to be associated with glycaemic control and variability. This study aims to identify the factors associated with HbA1c variability in type 2 diabetes mellitus (T2DM) patients. A retrospective cohort of T2DM patients who visited the clinics between January 2...

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Main Authors: Xin Rou Teh, Aslene Siu Tjing Yeoh, Azah Abdul Samad, Mastura Ismail, Sheamini Sivasampu
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-08346-y
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author Xin Rou Teh
Aslene Siu Tjing Yeoh
Azah Abdul Samad
Mastura Ismail
Sheamini Sivasampu
author_facet Xin Rou Teh
Aslene Siu Tjing Yeoh
Azah Abdul Samad
Mastura Ismail
Sheamini Sivasampu
author_sort Xin Rou Teh
collection DOAJ
description Abstract Diabetes complications were shown to be associated with glycaemic control and variability. This study aims to identify the factors associated with HbA1c variability in type 2 diabetes mellitus (T2DM) patients. A retrospective cohort of T2DM patients who visited the clinics between January 2017 and October 2022 were included. HbA1c variability were measured using coefficient of variation and standard deviation, and stratified using medians of 9.16 and 0.75, respectively. Logistic regressions was performed and subgroup analyses based on HbA1c control were included. We included 2,532 T2DM patients with a mean age of 61.7 years, predominantly female (55.8%) and of Chinese ethnicity (39%). Mean diabetes duration was 5.9 years and 45.8% were obese. Prevalence of HbA1c < 7.0% was about one-third. Predominant prescription choices were biguanides and sulphonylureas. Malays, insulin usage, and elevated triglyceride levels were associated with high HbA1c variability across both HbA1c variability models. This study highlights that by recognizing the factors linking to HbA1c variability, clinicians can have more insights during patient monitoring and management. HbA1c variability can be a valuable measure as it does not require additional cost and can provide extra insight about patient’s condition. Further investigation is needed to explore the impact of ethnicity on HbA1c variability.
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spelling doaj-art-d2b7ad35e9254fc9b01914143b1b00bb2025-08-20T03:42:38ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-08346-yDeterminants of HbA1c variability among type 2 diabetes mellitus patients in Malaysian primary care settingXin Rou Teh0Aslene Siu Tjing Yeoh1Azah Abdul Samad2Mastura Ismail3Sheamini Sivasampu4Institute for Clinical Research, National Institutes of Health, Ministry of HealthInstitute for Clinical Research, National Institutes of Health, Ministry of HealthSection 7 Health Clinic, Ministry of Health, Shah AlamFamily Health Development Division, Ministry of HealthInstitute for Clinical Research, National Institutes of Health, Ministry of HealthAbstract Diabetes complications were shown to be associated with glycaemic control and variability. This study aims to identify the factors associated with HbA1c variability in type 2 diabetes mellitus (T2DM) patients. A retrospective cohort of T2DM patients who visited the clinics between January 2017 and October 2022 were included. HbA1c variability were measured using coefficient of variation and standard deviation, and stratified using medians of 9.16 and 0.75, respectively. Logistic regressions was performed and subgroup analyses based on HbA1c control were included. We included 2,532 T2DM patients with a mean age of 61.7 years, predominantly female (55.8%) and of Chinese ethnicity (39%). Mean diabetes duration was 5.9 years and 45.8% were obese. Prevalence of HbA1c < 7.0% was about one-third. Predominant prescription choices were biguanides and sulphonylureas. Malays, insulin usage, and elevated triglyceride levels were associated with high HbA1c variability across both HbA1c variability models. This study highlights that by recognizing the factors linking to HbA1c variability, clinicians can have more insights during patient monitoring and management. HbA1c variability can be a valuable measure as it does not require additional cost and can provide extra insight about patient’s condition. Further investigation is needed to explore the impact of ethnicity on HbA1c variability.https://doi.org/10.1038/s41598-025-08346-y
spellingShingle Xin Rou Teh
Aslene Siu Tjing Yeoh
Azah Abdul Samad
Mastura Ismail
Sheamini Sivasampu
Determinants of HbA1c variability among type 2 diabetes mellitus patients in Malaysian primary care setting
Scientific Reports
title Determinants of HbA1c variability among type 2 diabetes mellitus patients in Malaysian primary care setting
title_full Determinants of HbA1c variability among type 2 diabetes mellitus patients in Malaysian primary care setting
title_fullStr Determinants of HbA1c variability among type 2 diabetes mellitus patients in Malaysian primary care setting
title_full_unstemmed Determinants of HbA1c variability among type 2 diabetes mellitus patients in Malaysian primary care setting
title_short Determinants of HbA1c variability among type 2 diabetes mellitus patients in Malaysian primary care setting
title_sort determinants of hba1c variability among type 2 diabetes mellitus patients in malaysian primary care setting
url https://doi.org/10.1038/s41598-025-08346-y
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