
A study evaluated the relationship between changes in HbA1c levels and cardiovascular disease (CVD) incidence in 128,843 patients with Type 2 diabetes mellitus (T2DM) over a median follow-up of 11.7 years. The study identified ten latent classes for younger patients with baseline HbA1c ≥ 8% and seven classes for other groups using joint latent class mixture models. Patients with fluctuating HbA1c trajectories, characterized by alternating periods of increase and decrease, exhibited higher CVD incidences. Male patients, those with higher baseline HbA1c, and those using antidiabetic drugs were more likely to experience fluctuating trajectories. These findings suggest that T2DM patients with variable HbA1c levels may have an increased CVD risk, highlighting the importance of individualized diabetes management strategies.
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