TMLE for assessing low HbA1c and mortality in non-diabetics

Application of Targeted Maximum Likelihood Estimation (TMLE) in evaluating the association between Low HbA1c and all-cause / cardiovascular mortality among people without diabetes

Why the research is needed?

The research is needed to address the unclear effects of low HbA1c levels on long-term health outcomes among non-diabetic individuals, as previous studies have shown inconsistent results. This is critical for understanding the clinical significance of low HbA1c and improving patient care.

What is already known about the subject?

HbA1c is a key biomarker for diabetes, with high levels associated with increased mortality and cardiovascular disease (CVD). However, low HbA1c levels have also been linked to increased risks in diabetic individuals, and their effects on non-diabetic individuals remain unclear.

Who we will be working with?

The project will be led by LRWE and ARC-EM, involving a multidisciplinary team of clinicians, clinical epidemiologists, and medical statisticians.

How patients and the public are involved?

Patients and the public will be involved through focus groups, surveys, and the development of user-friendly educational materials to enhance health literacy and support better health outcomes.

What we will do?

We will analyse data from nationally representative sources (CPRD, HES-APC, ONS) to evaluate the effects of HbA1c levels on mortality, considering demographic variables, comorbidities, and medication use.

What the benefits will be?

The findings will provide critical insights into the clinical significance of low HbA1c levels, improving evidence-based decision-making and patient care, and informing guidelines for high-risk non-diabetic individuals.

When the findings will be available?

The findings will be disseminated through peer-reviewed journals, conferences, and targeted outreach efforts upon completion of the study phases.

How we are planning for implementation?

We will engage healthcare professionals through seminars, workshops, and professional networks to translate research findings into clinical practice, ensuring evidence-based decision-making and improved patient outcomes.

Contact

Safoora Gharibzadeh, Research Fellow in Medical Statistics, University of Leicester, Sgh18@leicester.ac.uk.