HbA1c trajectories and the risk of liver-related events in patients with type 2 diabetes mellitus.

In a Hong Kong cohort of 294,096 adults with newly diagnosed type 2 diabetes mellitus, higher time-weighted average HbA1c predicted liver-related events (aCSHR 1.12 per 1%).

• Why it matters: Long-term glycaemic control and liver-related events in type 2 diabetes mellitus are unclear, limiting risk stratification and guidance on how to manage HbA1c over time.
• What they did: Using time-series clustering to define HbA1c trajectories (externally validated in UK Biobank), the study estimated associations with LREs via cause-specific hazards models with non-liver-related death as a competing risk.
• The result: Greater HbA1c variability and fewer years with HbA1c <7% were linked to higher LRE risk, and mild decreasing (aCSHR 1.30) and increasing (aCSHR 1.37) trajectories increased risk versus rapid decreasing.

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