title: Inpatient Glycemic Variability and Long-Term Mortality in Hospitalized Patients with Type 2 Diabetes.
abstract: OBJECTIVE
  To determine the association between inpatient glycemic variability and long-term mortality in patients with type 2 diabetes mellitus.
  
  
  METHODS
  Capillary blood glucose (CBG) of inpatients from 8 hospitals was analysed. 28,353 admissions identified were matched for age, duration of diabetes and admission and median and interquartile range of CBG. 6year mortality was investigated for (i) those with CBG IQR in the top half of all IQR measurements (matched for all except IQR), vs those in the lower half and (ii) those with the lowest quartile median glucose (matched for all except median).
  
  
  RESULTS
  CONCLUSION: Higher inpatient glycemic variability is associated with increased mortality on long-term follow up. When matched by IQR, we have demonstrated higher median CBG is associated with lower long-term mortality. CBG variability may increase cardiovascular morbidity by increasing exposure to hypoglycaemia or to variability per se. In hospitalized patients with diabetes, glycemic variability should be minimised and when greater CBG variability is unavoidable, a less stringent CBG target considered.
authors.affiliation: Diabetes Centre, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 OYN, Scotland, United Kingdom.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Timmons
authors.affiliation: Clinical Technology Centre, Ninewells Hospital, Dundee, DD2 1UB, Scotland, United Kingdom.
authors.forename: Scott G
authors.initials: SG
authors.lastname: Cunningham
authors.affiliation: Diabetes Centre, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 OYN, Scotland, United Kingdom.
authors.forename: Christopher A R
authors.initials: CA
authors.lastname: Sainsbury
authors.affiliation: Diabetes Centre, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 OYN, Scotland, United Kingdom. Electronic address: g.jones3@nhs.net.
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Jones
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality / Q000517:prevention & control; D016022:Case-Control Studies; D003131:Combined Modality Therapy / Q000009:adverse effects; D048909:Diabetes Complications / Q000401:mortality / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000401:mortality / Q000517:prevention & control; D058065:Diabetic Cardiomyopathies / Q000401:mortality / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012042:Registries; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D016019:Survival Analysis
chemical_list: D001786:Blood Glucose
keywords: Diabetes; Glucose variability; Hypoglycaemia; Inpatient care; Mortality