Journal
DIABETES & METABOLISM
Volume 47, Issue 1, Pages -Publisher
MASSON EDITEUR
DOI: 10.1016/j.diabet.2020.05.003
Keywords
Mortality; Retrospective cohort study; Type 2 diabetes; Variability; Visit-to-visit fasting glucose
Categories
Funding
- Shanghai Municipal Natural Science Foundation [19ZR1445900]
- National Natural Science Foundation of China [11871164]
- Natural Science Foundation of Minhang District, Shanghai, China [2019MHZ010]
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The study revealed that in people with type 2 diabetes, variability in visit-to-visit fasting glucose may be a more sensitive predictor of risk of death than mean fasting glucose.
Aim. - To investigate the association between mean fasting glucose (FG) and variability in visit-to-visit FG and risk of mortality in people with type 2 diabetes (T2D). Methods. - This retrospective cohort study included 48,077 Chinese men and women with T2D. The yearly mean and coefficient of variation for fasting glucose (mean-FG and FG-CV, respectively) were based on at least two measurements taken each year over a mean duration of 4.5 years. Deaths and their causes were identified using the Shanghai Vital Statistics registry. Mean-FG and FG-CV served as time-dependent variables in Cox models to estimate their associations with risk of mortality; hazard ratios (HRs) were adjusted for baseline risk factors. Potential non-linear associations were examined by restricted cubic splines. Results. - During an average 4.5 years of follow-up, 2095 men and 1923 women died. Men with low mean-FG and women with low or high FG were at greater risk of death. Mean-FG was not associated with either cardiovascular disease (CVD) or cancer-specific mortality, whereas higher yearly FG-CV was associated with all-cause and CVD-/cancer-specific mortality in both genders. Compared with a yearly FG-CV of 1.76 (5th percentile), men and women with an FG-CV of 14.14 (75th percentile) had HRs (95% CI) of 1.41 (1.24-1.61) and 1.44 (1.26-1.65), respectively, for all-cause mortality. Conclusion. - Variability of visit-to-visit FG may be a more sensitive predictor of risk of death than mean-FG in people with T2D. (C) 2020 Published by Elsevier Masson SAS.
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