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Diabetes Care. 2018 Dec;41(12):2610-2616. doi: 10.2337/dc18-0802. Epub 2018 Sep 25.

Impact of Visit-to-Visit Fasting Plasma Glucose Variability on the Development of Type 2 Diabetes: A Nationwide Population-Based Cohort Study.

Author information

1
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
2
Clinical Research Center, Asan Medical Center, College of Medicine, Ulsan University, Seoul, Korea.
3
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea medica7@gmail.com.

Abstract

OBJECTIVE:

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.

RESEARCH DESIGN AND METHODS:

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).

RESULTS:

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.

CONCLUSIONS:

Increased variability of FPG is associated with the development of T2D independently of diverse risk factors.

PMID:
30254081
DOI:
10.2337/dc18-0802
[Indexed for MEDLINE]

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