title: Impaired fasting plasma glucose and type 2 diabetes are related to the risk of out-of-hospital sudden cardiac death and all-cause mortality.
abstract: OBJECTIVE
  The aim of the study was to determine whether impaired fasting plasma glucose (FPG) and type 2 diabetes may be risk factors for sudden cardiac death (SCD).
  
  
  METHODS
  This prospective study was based on 2,641 middle-aged men 42-60 years of age at baseline. Impaired FPG level (≥5.6 mmol/L) among nondiabetic subjects (501 men) was defined according to the established guidelines, and the group with type 2 diabetes included subjects (159 men) who were treated with oral hypoglycemic agents, insulin therapy, and/or diet.
  
  
  RESULTS
  During the 19-year follow-up, a total of 190 SCDs occurred. The relative risk (RR) for SCD was 1.51-fold (95% CI 1.07-2.14, P = 0.020) for nondiabetic men with impaired FPG and 2.86-fold (1.87-4.38, P < 0.001) for men with type 2 diabetes as compared with men with normal FPG levels, after adjustment for age, BMI, systolic blood pressure, serum LDL cholesterol, smoking, prevalent coronary heart disease (CHD), and family history of CHD. The respective RRs for out-of-hospital SCDs (157 deaths) were 1.79-fold (1.24-2.58, P = 0.001) for nondiabetic men with impaired FPG and 2.26-fold (1.34-3.77, P < 0.001) for men with type 2 diabetes. Impaired FPG and type 2 diabetes were associated with the risk of all-cause death. As a continuous variable, a 1 mmol/L increment in FPG was related to an increase of 10% in the risk of SCD (1.10 [1.04-1.20], P = 0.001).
  
  
  CONCLUSIONS
  Impaired FPG and type 2 diabetes represent risk factors for SCD.
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. jariantero.laukkanen@uef.fi
authors.forename: Jari A
authors.initials: JA
authors.lastname: Laukkanen
authors.forename: Timo H
authors.initials: TH
authors.lastname: Mäkikallio
authors.forename: Kimmo
authors.initials: K
authors.lastname: Ronkainen
authors.forename: Jouni
authors.initials: J
authors.lastname: Karppi
authors.forename: Sudhir
authors.initials: S
authors.lastname: Kurl
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002423:Cause of Death; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000401:mortality*; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose