LONGITUDINAL PATTERNS OF GLYCEMIC CONTROL AMONG PATIENTS WITH DIABETES

Abstract

Glycemic control is the primary strategy to improve diabetes-related outcomes in patients with diabetes. In clinical practice, glycated hemoglobin (HbA1c) is routinely measured to evaluate level of glycemic control. These serial measurements of HbA1c form a trajectory of glycemic control, reflecting the progression of diabetes for each patient. This thesis analyzed longitudinal HbA1c patterns among patients with diabetes using data from the Singapore Population Health Studies-Diabetic Cohort. The following aspects were analyzed: (1) identifying distinct glycemic control patterns using latent class growth analysis; (2) examining the associations of these patterns with patient characteristics, control of cardiovascular biomarkers, and future risk of diabetes-related complications and all-cause mortality; (3) analyzing the influence of antidiabetic medication usage on the shaping of these patterns. These findings have a bearing on the management of diabetes in clinical practice and the allocation of resources and services in the healthcare system.