Journal of the Formosan Medical Association (May 2016)

The impact of ambient temperature on HbA1c in Taiwanese type 2 diabetic patients: The most vulnerable subgroup

  • Kai-Jen Tien,
  • Chwen-Yi Yang,
  • Shih-Feng Weng,
  • Su-Yen Liu,
  • Ming-Chia Hsieh,
  • Chien-Wen Chou

DOI
https://doi.org/10.1016/j.jfma.2015.03.010
Journal volume & issue
Vol. 115, no. 5
pp. 343 – 349

Abstract

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The relationship between temperature variability and HbA1c has been reported in Caucasians, but not for Asians of Taiwanese origin. This study investigated the impact of temperature on HbA1c in various groups of Taiwanese with type 2 diabetes in Taiwan. Methods: For this longitudinal follow-up study which started in 2006, we recruited a total of 4399 patients with type 2 diabetes who had been regularly followed up at Chi Mei Medical Center and obtained local temperature data for 2006 to 2011 from Taiwan's Central Weather Bureau. We used a generalized estimated equation (GEE) to analyze the HbA1c level and its change over time with temperature and temperature changes, respectively. Results: We found a negative correlation between HbA1c and temperature (R = −0.475, p = 0.001). For every 1°C decrement in temperature, there was an increase in the risk of having a HbA1c level >7% [p 7% among those in the lowest quartile of temperatures than the highest quartile (p = 0.0038, adjusted OR: 1.13). Patients with diabetic patients were at higher risk of HbA1C > 7% in the winter and spring than those in the summer (adjusted OR: 1.13, p = 0.0027; adjusted OR: 1.14, p = 0.0022). After adjusting for various confounders, we found people who were younger than 65 years old, people who had diabetes for longer than 6 years, and people who had a body mass index (BMI) < 24 to be more susceptible to temperature changes (p = 0.0022, β: 0.0095; p < 0.0001, β: 0.0125; p < 0.0001, β: 0.016, respectively). Conclusion: Our study suggests cold weather may adversely affect HbA1c levels in Taiwanese people with type 2 diabetes, especially in people under 65 years old, people with diabetes for longer than 6 years, and those with a BMI < 24.

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