title: Fasting plasma glucose variability and all-cause mortality among type 2 diabetes patients: a dynamic cohort study in Shanghai, China.
abstract: The study aims to examine whether the variation of fasting plasma glucose (FPG), represented by coefficient of variation (CV), independently predicts all-cause mortality among Chinese type 2 diabetes patients. This retrospective cohort study was designed based on a standardized electronic management system of diabetes patients in Shanghai, China. 8871 type 2 diabetes patients were enrolled between 1 January 2007 and 31 December 2007 and were followed-up for all-cause mortality until 31 December 2014. All patients were grouped by the quartiles of CV of FPG. 1136 patients deceased during following-up. After adjusting for other risk factors, CV of FPG was not independently associated with all-cause mortality. Stratified analysis by mean FPG levels (<7 mmol/L and ≥7 mmol/L) observed a significant modifying effect of CV of FPG (P for interact test <0.01). CV of FPG was independently associated with all-cause mortality in patients whose glucose control was poor, with the HRs (95% CI) for the second, third, fourth vs first quartiles of CV of FPG being 1.23(0.94-1.61), 1.23(0.94-1.61), and 1.63(1.25-2.13), respectively. Our results suggest that variability of FPG may be an important predictor of mortality among type 2 diabetes in China, particularly for those with their glycemic status uncontrolled.
authors.affiliation: Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Dongli
authors.initials: D
authors.lastname: Xu
authors.affiliation: Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Fang
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education (Fudan University), Shanghai, China.
authors.forename: Wanghong
authors.initials: W
authors.lastname: Xu
authors.affiliation: Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Yinan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China.
authors.forename: Baodong
authors.initials: B
authors.lastname: Yao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D002318:Cardiovascular Diseases / Q000150:complications; D002681:China; D015331:Cohort Studies; D048909:Diabetes Complications / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology*; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia; D007328:Insulin / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000150:complications / Q000401:mortality; D011336:Probability; D016016:Proportional Hazards Models; D012307:Risk Factors; D012923:Social Class; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin