Journal of diabetes investigation 2016 12 15() doi 10.1111/jdi.12610
We evaluated the impact of postprandial hyperglycemia at clinic visits on the incidence of cardiovascular diseases (CVD) and all-cause mortality independently of mean glycosylated hemoglobin (HbA1c) in type 2 diabetes patients in a real-world setting.
MATERIALS AND METHODS
This retrospective observational cohort study included 646 type 2 diabetes patients. All of the subjects had their initial consultations at our clinic during the period from 1995-1996, visited the clinic ≥4 times, had their 2-hour post-breakfast blood glucose (2h-PBBG) levels measured, and were followed-up for ≥1 year. The 646 patients were followed-up for survival. Of the 646 patients, 618 had no history of CVD at the first visit and had measured 2h-PBBG until the first CVD onset or censorings. These two cohorts were followed-up through June 2012, and subsequently questionnaires were mailed. Risks of the CVD incidence and death were evaluated by multivariate Cox proportional hazard models.
CVD occurred in 78 patients and death in 56. The median follow-up periods of the CVD cohort and the mortality cohort were 15.6 years and 15.9 years, respectively. The mean 2h-PBBG is a significant predictor of the CVD incidence and all-cause mortality after adjusting for the mean HbA1c, the number of 2h-PBBG measurements, age, sex and classical risk factors.
Postprandial hyperglycemia represented by the mean level of 2h-PBBG at clinic visits is associated with the CVD incidence and all-cause mortality independently of the mean HbA1c level in type 2 diabetes patients. Prospective interventional trials are warranted to confirm our findings. This article is protected by copyright. All rights reserved.