4.7 Article

Fasting plasma glucose variability and HbA1c are associated with peripheral artery disease risk in type 2 diabetes

Journal

CARDIOVASCULAR DIABETOLOGY
Volume 19, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12933-019-0978-y

Keywords

HbA1c; Fasting plasma glucose; Glycemic variability; Peripheral artery disease

Funding

  1. Bureau of National Health Insurance [DOH94-NH-1007]
  2. Ministry of Science and Technology of Taiwan [MOST 104-2314-B-039-016, MOST 105-2314-B-039-021-MY3, MOST 105-2314-B-039-025-MY3, MOST 107-2314-B-039-049, MOST 108-2314-B-039-039, MOST 108-2314-B-039-035-MY3, MOST 108-2314-B-039-031-MY2]
  3. China Medical University [CMU108-S-07]

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Background This study investigated whether visit-to-visit fasting plasma glucose (FPG) variability, as measured by the coefficient of variation (CV), increased peripheral artery disease (PAD) risk. Methods Individuals with type 2 diabetes from the National Diabetes Care Management Program during the period 2002-2004, >= 30 years of age, and free of PAD (n = 30,932) were included and monitored until 2011. Cox proportional hazards regression models were implemented to analyze related determinants of PAD. Results A total of 894 incident cases of PAD were identified during an average 8.2 years of follow-up, resulting in a crude incidence rate of 3.53 per 1000 person-years. Both FPG-CV and HbA1c were significantly associated with PAD after multivariate adjustment, with corresponding hazard ratios of 1.24 [95% confidence interval (CI) 1.04-1.47] for FPG-CV in the third tertile and 1.50 (95% CI 1.10-2.04) for HbA1c >= 10%. The findings of the sensitivity analysis remained consistent after excluding potential confounders, demonstrating the consistency of the results. Conclusions The associations between HbA1c, variability in FPG-CV, and PAD suggest a linked pathophysiological mechanism, suggesting the crucial role of glycemic variability in clinical management and therapeutic goals in preventing PAD in type 2 diabetes.

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