Effect of glycemia on mortality in Pima Indians with type 2 diabetes

The effect of plasma glucose concentration on overall and cause-specific mo rtality was examined in 1,745 Pima Indians (725 men, 1,020 women) greater t han or equal to 15 years old with type 2 diabetes. During a median follow-u p of 10.6 years (range 0.1-24.8), 533 subjects (275 men, 258 women) died; 1 13 of the deaths were attributable to cardiovascular disease, 96 to diabete s-related diseases (diabetic nephropathy for 92 of these), 249 to other nat ural causes, and 75 to external causes. After adjusting for age, sex, durat ion of diabetes, and BMI in a generalized additive proportional hazards mod el, higher baseline 2-h postload plasma glucose concentration predicted dea ths from cardiovascular disease (P = 0.007) and diabetes-related diseases ( P = 0.003), but not from other natural causes (P = 0.73), An increment of 5 .6 mmol/l (100 mg/dl) in the 2-h plasma glucose concentration was associate d with 1.2 times (95% CI 1.1-1.4) the death rate from cardiovascular diseas e, 1.3 times (95% CI 1.1-1.5) the death rate from diabetes-related diseases , and almost no change in the death rate from other natural causes (rate ra tio = 1.0; 95% CI 0.94-1.1), In Pima Indians with type 2 diabetes, higher p lasma glucose concentration predicts deaths from cardiovascular and diabete s-related diseases but has little or no effect on deaths from other natural or external causes.