Long-term blood sugar patterns after type 2 diabetes diagnosis reveal distinct risks of complications.
Not all patients with type 2 diabetes follow the same blood sugar journey, and those with more variable long-term patterns face higher complication risks. A cohort study published in BMJ Open Diabetes Research & Care analyzed long-term HbA1c trajectories and their association with complications in adults with type 2 diabetes (T2D). The study included 12,435 unrelated individuals of European ancestry from the UK Biobank, with linked primary care records. Latent class growth mixture modeling was applied to identify six HbA1c trajectory over the 10 years following T2D diagnosis.

The largest class (76.8%) maintained low and stable HbA1c levels. The remaining five classes exhibited higher and more variable trajectories and were associated with younger age at diagnosis.  Compared with the low-stable class, these variable trajectories were linked to increased risks of stroke (HR=1.55), kidney disease (HR=1.39), all-cause mortality (HR=1.36), and progression to combination therapy (HR=3.22) or insulin (HR=3.21).

The findings suggest that early identification of patients likely to follow variable HbA1c trajectories may help guide closer monitoring and interventions to reduce long-term complications.