Should studies of diabetes treatment stratification correct for baseline HbA1c?

Angus G. Jones (Lead / Corresponding author), Mike Lonergan, William E. Henley, Ewan R. Pearson, Andrew T. Hattersley, Beverley M. Shields

    Research output: Contribution to journalArticlepeer-review

    23 Citations (Scopus)
    153 Downloads (Pure)


    Aims: Baseline HbA1c is a major predictor of response to glucose lowering therapy and therefore a potential confounder in studies aiming to identify other predictors. However, baseline adjustment may introduce error if the association between baseline HbA1c and response is substantially due to measurement error and regression to the mean. We aimed to determine whether studies of predictors of response should adjust for baseline HbA1c. 

    Methods: We assessed the relationship between baseline HbA1c and glycaemic response in 257 participants treated with GLP-1R agonists and assessed whether it reflected measurement error and regression to the mean using duplicate 'pre-baseline' HbA1c measurements not included in the response variable. In this cohort and an additional 2659 participants treated with sulfonylureas we assessed the relationship between covariates associated with baseline HbA1c and treatment response with and without baseline adjustment, and with a bias correction using pre-baseline HbA1c to adjust for the effects of error in baseline HbA1c. 

    Results: Baseline HbA1c was a major predictor of response (R2 = 0.19,β = -0.44,p

    Original languageEnglish
    Article numbere0152428
    Number of pages14
    JournalPLoS ONE
    Issue number4
    Publication statusPublished - 6 Apr 2016

    ASJC Scopus subject areas

    • General Agricultural and Biological Sciences
    • General Biochemistry,Genetics and Molecular Biology
    • General Medicine


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