title: Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study.
abstract: OBJECTIVE
  To evaluate whether postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a long-term follow-up taking into account A1C and the main cardiovascular risk factors.
  
  
  METHODS
  Consecutive type 2 diabetic patients (n = 505) followed up at our diabetes clinic were evaluated at baseline (1995) for the main cardiovascular risk factors and for five glycemic control parameters (fasting blood glucose, blood glucose 2 h after breakfast, blood glucose 2 h after lunch, blood glucose before dinner, and A1C); all-cause mortality and the first cardiovascular events occurring during the 14-year follow-up were measured.
  
  
  RESULTS
  We observed 172 cardiovascular events (34.1% of the population) and 147 deaths (29.1% of the population). Using the Cox analysis with the backward method, we categorized the variables according to the therapeutic targets of the American Diabetes Association. Our observations were as follows. When the five glycemic control parameters were considered together, the predictors were 1) for cardiovascular events, blood glucose 2 h after lunch (hazard ratio 1.507, P = 0.010) and A1C (1.792, P = 0.002); and 2) for mortality, blood glucose 2 h after lunch (1.885, P < 0.0001) and A1C (1.907, P = 0.002). When blood glucose 2 h after lunch and A1C were considered together with the main cardiovascular risk factors, the following glycemic control parameters were predictors: 1) for cardiovascular events, blood glucose 2 h after lunch (1.452, P = 0.021) and A1C (1.732, P = 0.004); and 2) for mortality, blood glucose 2 h after lunch (1.846, P = 0.001) and A1C (1.896, P = 0.004).
  
  
  CONCLUSIONS
  In type 2 diabetes, both postprandial blood glucose and A1C predict cardiovascular events and all-cause mortality in a long-term follow-up.
authors.affiliation: Medicine and Metabolic Disease Unit, Department of Clinical and Biological Sciences, San Luigi Gonzaga Faculty of Medicine of Turin University, San Luigi Gonzaga Hospital, Turin, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Cavalot
authors.forename: Andrea
authors.initials: A
authors.lastname: Pagliarino
authors.forename: Manuela
authors.initials: M
authors.lastname: Valle
authors.forename: Leonardo
authors.initials: L
authors.lastname: Di Martino
authors.forename: Katia
authors.initials: K
authors.lastname: Bonomo
authors.forename: Paola
authors.initials: P
authors.lastname: Massucco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Anfossi
authors.forename: Mariella
authors.initials: M
authors.lastname: Trovati
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000378:metabolism / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D016016:Proportional Hazards Models
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin