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Variation of fasting plasma glucose: a predictor of mortality in patients with type 2 diabetes.
Am J Med. 2012 Apr; 125(4):416.e9-18.AJ

Abstract

BACKGROUND

The aim of this study was to examine whether time-dependent annual fasting plasma glucose (FPG) variation, as represented by coefficient of variation (CV), can predict mortality in subsequent all-cause, expanded, and nonexpanded cardiovascular disease-related mortality independent of mean FPG, renal function, mean hemoglobin A(1)C (HbA(1C)), HbA(1C) variation, and other risk factors in patients with type 2 diabetes.

METHODS

A computerized database of all patients with type 2 diabetes aged 30 years and over (n = 5008) enrolled in the Diabetes Care Management Program of China Medical University Hospital before 2007 was used in a time-dependent Cox proportional hazard regression model.

RESULTS

The mortality rates were 8.64, 12.71, and 30.82 per 1000 person-years in groups of first, second, and third tertiles of baseline FPG-CV, respectively. Among these patients with type 2 diabetes, 336, 1191, 914, 585, and 1979 patients provided 1, 2, 3, 4, and 5 or more years of annual FPG-CV measurements, respectively. After adjusting for mean FPG, mean HbA(1C), HbA(1C) variation, and other risk factors, annual FPG-CV was independently associated with all-cause mortality and mortality due to expanded and nonexpanded cardiovascular disease, and the corresponding hazard ratios for third versus first tertile of annual FPG-CV were 5.53 (95% confidence interval [CI], 3.85-7.94), 3.21 (95% CI, 2.00-5.15), and 9.45 (95% CI, 5.37-16.63), respectively.

CONCLUSIONS

Time-dependent variation of FPG was a strong predictor of all-cause, expanded, and nonexpanded cardiovascular disease-related mortality in patients with type 2 diabetes, suggesting that glucose variation may become a measure in clinical practice for the goal in the management of these patients.

Authors+Show Affiliations

Department of Family Medicine, China Medical University, Taichung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22305579

Citation

Lin, Cheng-Chieh, et al. "Variation of Fasting Plasma Glucose: a Predictor of Mortality in Patients With Type 2 Diabetes." The American Journal of Medicine, vol. 125, no. 4, 2012, pp. 416.e9-18.
Lin CC, Li CI, Yang SY, et al. Variation of fasting plasma glucose: a predictor of mortality in patients with type 2 diabetes. Am J Med. 2012;125(4):416.e9-18.
Lin, C. C., Li, C. I., Yang, S. Y., Liu, C. S., Chen, C. C., Fuh, M. M., Chen, W., & Li, T. C. (2012). Variation of fasting plasma glucose: a predictor of mortality in patients with type 2 diabetes. The American Journal of Medicine, 125(4), e9-18. https://doi.org/10.1016/j.amjmed.2011.07.027
Lin CC, et al. Variation of Fasting Plasma Glucose: a Predictor of Mortality in Patients With Type 2 Diabetes. Am J Med. 2012;125(4):416.e9-18. PubMed PMID: 22305579.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variation of fasting plasma glucose: a predictor of mortality in patients with type 2 diabetes. AU - Lin,Cheng-Chieh, AU - Li,Chia-Ing, AU - Yang,Sing-Yu, AU - Liu,Chiu-Shong, AU - Chen,Ching-Chu, AU - Fuh,Martin Mao-Tsu, AU - Chen,Walter, AU - Li,Tsai-Chung, Y1 - 2012/02/02/ PY - 2011/01/31/received PY - 2011/04/14/revised PY - 2011/07/19/accepted PY - 2012/2/7/entrez PY - 2012/2/7/pubmed PY - 2012/5/15/medline SP - 416.e9 EP - 18 JF - The American journal of medicine JO - Am J Med VL - 125 IS - 4 N2 - BACKGROUND: The aim of this study was to examine whether time-dependent annual fasting plasma glucose (FPG) variation, as represented by coefficient of variation (CV), can predict mortality in subsequent all-cause, expanded, and nonexpanded cardiovascular disease-related mortality independent of mean FPG, renal function, mean hemoglobin A(1)C (HbA(1C)), HbA(1C) variation, and other risk factors in patients with type 2 diabetes. METHODS: A computerized database of all patients with type 2 diabetes aged 30 years and over (n = 5008) enrolled in the Diabetes Care Management Program of China Medical University Hospital before 2007 was used in a time-dependent Cox proportional hazard regression model. RESULTS: The mortality rates were 8.64, 12.71, and 30.82 per 1000 person-years in groups of first, second, and third tertiles of baseline FPG-CV, respectively. Among these patients with type 2 diabetes, 336, 1191, 914, 585, and 1979 patients provided 1, 2, 3, 4, and 5 or more years of annual FPG-CV measurements, respectively. After adjusting for mean FPG, mean HbA(1C), HbA(1C) variation, and other risk factors, annual FPG-CV was independently associated with all-cause mortality and mortality due to expanded and nonexpanded cardiovascular disease, and the corresponding hazard ratios for third versus first tertile of annual FPG-CV were 5.53 (95% confidence interval [CI], 3.85-7.94), 3.21 (95% CI, 2.00-5.15), and 9.45 (95% CI, 5.37-16.63), respectively. CONCLUSIONS: Time-dependent variation of FPG was a strong predictor of all-cause, expanded, and nonexpanded cardiovascular disease-related mortality in patients with type 2 diabetes, suggesting that glucose variation may become a measure in clinical practice for the goal in the management of these patients. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/22305579/Variation_of_fasting_plasma_glucose:_a_predictor_of_mortality_in_patients_with_type_2_diabetes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(11)00645-0 DB - PRIME DP - Unbound Medicine ER -