M. Muggeo et al., Fasting plasma glucose variability predicts 10-year survival of type 2 diabetic patients - The Verona Diabetes Study, DIABET CARE, 23(1), 2000, pp. 45-50
OBJECTIVE- In the present study, we evaluated whether the coefficient of va
riation (CV) of fasting plasma glucose (FPG) over a 3-year period was a sig
nificant predictor of mortality in type 2 diabetic patients aged 56-74 year
s.
RESEARCH DESIGN AND METHODS- All type 2 diabetic patients (n = 1,409) aged
56-74 years attending the Verona Diabetes Clinic and having at least two FP
G determinations in each of the years 1983-1986 were followed for 10 years
(1987-1996) to assess total and cause-specific mortality. Patients were gro
uped into tertiles of mean and CV of FPG during 1984-1986. These parameters
as well as sex, age, diabetes duration, insulin treatment, smoking, hypert
ension, and hypercholesterolemia were included in multivariate survival ana
lyses.
RESULTS- During the follow-up, 468 patients died. The CV of FPG was an inde
pendent predictor of total, cardiovascular, and cancer mortality. Mean FPG
was a predictor of total mortality only when the CV of FPG was not included
in the analyses.
CONCLUSIONS- Long-term variability of fasting glucose is an independent pre
dictor of mortality in patients with type 2 diabetes. The CV of FPG might b
e considered a useful additional parameter in the management of these patie
nts.