Relationship between blood glucose level and mortality in type 2 diabetes mellitus: a systematic review.
OBJECTIVE
To review the relationship between blood glucose level and mortality in patients with Type 2 diabetes mellitus (DM) as reported in the literature.


METHODS
Literature search using Medline Search: January 1966 - April 1998.


BACKGROUND
Diabetes, Non Insulin Dependent, Mortality. Inclusion criteria for papers were: Type 2 DM; follow-up for at least 3 years; glucose or glycated haemoglobin (HbA1c) was used as parameter; published in the form of an article. Additionally all references in the selected articles that dealt with the relationship between blood glucose level and mortality in Type 2 DM were included in the search.


RESULTS
Twenty-seven eligible articles were found. Twenty-three of them showed a positive association: measures of elevated blood glucose concentrations were associated with higher mortality; in 15 out of 23 studies the positive association was statistically significant, in two only for postprandial blood glucose. One study found a nonsignificant negative relationship in a very old population.


CONCLUSIONS
In the literature there is a positive, but rather weak, association between the measures of blood glucose control and the risk of dying of patients with Type 2 DM. In the six larger studies (more than 100 deceased patients) that used a continuous categorization of glycaemia, the Risk ratio per unit varies from 1.03 to 1.12.
Groeneveld
Y
Y
Department of General Practice, Leiden University Medical Centre, The Netherlands. Y.Groeneveld@genpractice.MedFac.LeidenUniv.NL
Petri
H
H
Hermans
J
J
Springer
M P
MP
D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000401:mortality; D006801:Humans; D012307:Risk Factors
D001786:Blood Glucose