J Korean Med Sci.  2014 Apr;29(4):550-555. 10.3346/jkms.2014.29.4.550.

Seasonal Variation in Hemoglobin A1c in Korean Patients with Type 2 Diabetes Mellitus

• Kim YJ
• Park S
• Yi W
• Yu KS
• Kim TH
• Oh TJ
• Choi J
• Cho YM

• KMID: 1774461
• DOI: http://doi.org/10.3346/jkms.2014.29.4.550

Abstract

A seasonal variation of glucose homeostasis in humans has been reported in various geographic regions. In this study, we examined seasonal variations in hemoglobin A1c (HbA1c) in patients with type 2 diabetes living in Korea. We analyzed 57,970 HbA1c values from 4,191 patients and the association of these values with ambient temperature for 3.5 yr. Overall, HbA1c exhibited its highest values from February to March and its lowest values from September to October (coefficient for cos t = -0.0743, P = 0.058) and the difference between the peak and nadir in a year was 0.16%-0.25%. A statistically significant seasonal variation was observed in the patients who were taking oral anti-diabetic drugs (OADs) without insulin treatment (coefficient for cos t = -0.0949, P < 0.05). The Spearman correlation coefficient between daily HbA1c values and the corresponding 3-month moving average ambient temperature was -0.2154 (95% confidence interval [CI]: -0.2711, -0.1580; P < 0.05). In conclusion, HbA1c values exhibited a seasonal variation in Korean patients with type 2 diabetes, with the highest values during the cold season, particularly in those who were treated with OADs, which should be taken into account in clinical practice for stable glucose control during the cold season.

Keyword

Diabetes Mellitus, Type 2; Hemoglobin A, Glycosylated; Seasonal Variation

MeSH Terms

Anti-Bacterial Agents/therapeutic use
Asian Continental Ancestry Group
Bacterial Infections/prevention & control
Diabetes Mellitus, Type 2/*diagnosis/drug therapy
Hemoglobin A, Glycosylated/*analysis
Humans
Hypoglycemic Agents/therapeutic use
Insulin/therapeutic use
Republic of Korea
Seasons
Temperature
Anti-Bacterial Agents
Hemoglobin A, Glycosylated
Hypoglycemic Agents
Insulin

Figure

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  Fig. 1 Flow chart of patient selection and grouping. n, number of patients; OADs, oral anti-diabetic drugs. *Add-on insulin therapy or insulin-only therapy.

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  Fig. 2 Temporal variation in monthly mean HbA1c, observed levels and predicted levels using the time series model in the overall population (A) and in the group taking oral anti-diabetic drugs only (B).

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