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- Title
Impact of Visit-to-Visit Fasting Plasma Glucose Variability on the Development of Type 2 Diabetes: A Nationwide Population-Based Cohort Study.
- Authors
Kim, Jung A.; Ji Sung Lee; Hye Soo Chung; Eun Roh; You-Bin Lee; So-hyeon Hong; Nam Hoon Kim; Hye Jin Yoo; Ji A. Seo; Sin Gon Kim; Nan Hee Kim; Sei Hyun Baik; Kyung Mook Choi; Lee, Ji Sung; Chung, Hye Soo; Roh, Eun; Lee, You-Bin; Hong, So-Hyeon; Kim, Nam Hoon; Yoo, Hye Jin
- Abstract
<bold>Objective: </bold>Although increasing evidence suggests the association between short-term variability of fasting plasma glucose (FPG) and diabetic complications or mortality, the impact of visit-to-visit variability of FPG on the development of type 2 diabetes (T2D) has not been evaluated.<bold>Research Design and Methods: </bold>Our analysis included 131,744 Korean men and women without diabetes using the Korean National Health Insurance System cohort with periodic health examination program. FPG variability was calculated using the coefficient of variation (FPG-CV), SD (FPG-SD), and variability independent of the mean (FPG-VIM).<bold>Results: </bold>During the median follow-up time of 8.3 years, Kaplan-Meier curves demonstrated lower disease-free probability in the higher FPG variability group compared with the lower FPG variability group. Multivariable Cox proportional hazards analysis exhibited that the hazard ratio for incident T2D was 1.67 (95% CI 1.58-1.77, P < 0.001) in the highest quartile of FPG-CV compared with the lowest quartile of FPG-CV after adjusting for confounding variables, including mean FPG. The association between FPG variability and the risk of T2D was consistent when modeling using FPG-SD and FPG-VIM in both normal and impaired fasting glucose groups. A 1 SD increase in the FPG-CV was associated with a 24% increased risk of T2D in the fully adjusted model.<bold>Conclusions: </bold>Increased variability of FPG is associated with the development of T2D independently of diverse risk factors.
- Subjects
SOUTH Korea; TYPE 2 diabetes; GLUCOSE; GLYCEMIC control; BLOOD sugar; OXIDATIVE stress; OUTPATIENT medical care; COMPARATIVE studies; FASTING; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PREDIABETIC state; RESEARCH; EVALUATION research; RESEARCH bias; DISEASE progression
- Publication
Diabetes Care, 2018, Vol 41, Issue 12, p2610
- ISSN
0149-5992
- Publication type
Academic Journal
- DOI
10.2337/dc18-0802