ABSTRACT
Objective:
To investigate the
association between long-term
fasting blood glucose (FPG) variability and all-cause
mortality in
patients with
type 2 diabetes.
Methods:
A total of 7 174 type 2 diabetic
patients included in National Basic
Public Health Service Program in Changshu of Jiangsu Province were recruited as participants. Long-term
glucose variability was assessed using standard deviation (SD), coefficient of variation (CV), average real variability (ARV), and variability independent of the mean (VIM) across FPG measurements at the more than three visits.
Death information were mainly obtained from the
death registry system in Jiangsu. Then Cox proportional
hazards regression models were used to estimate the
associations of four variability
indicators and all-cause
mortality's
hazard ratios (HRs) and their 95%CIs.
Results:
Among 55 058.50
person-years of the follow-up, the mean follow-up
time was 7.67 years, and 898 deaths occurred during the follow-up period. After
adjustment, compared with T1 group, the Cox regression model showed that HRs of T3 group in SD, CV, ARV and VIM were 1.24 (95%CI 1.03-1.49), 1.20 (95%CI 1.01-1.43), 1.28 (95%CI 1.07-1.55) and 1.20 (95%CI1.01-1.41), respectively. HRs of per 1 SD higher SD, CV, ARV and VIM were 1.13 (95%CI 1.06-1.21), 1.08 (95%CI 1.01-1.15), 1.05 (95%CI 1.00-1.12) and 1.09 (95%CI 1.02-1.16) for all-cause
mortality, respectively. In the stratified
analysis, age,
gender,
hypoglycemic agent and
insulin uses had no effect on the above
associations (all P for interaction >0.05).
Conclusion:
Long-term FPG glycemic variability was positively associated with the
risk of all-cause
mortality in
type 2 diabetes patients.