Association between postprandial hyperglycemia at clinic visits and all-cause and cancer mortality in patients with type 2 diabetes: A long-term historical cohort study in Japan

Diabetes Res Clin Pract. 2019 Feb:148:152-159. doi: 10.1016/j.diabres.2019.01.006. Epub 2019 Jan 11.

Abstract

Aims: To evaluate the effect of postprandial hyperglycemia at clinic visits on all-cause and cancer mortality independent of glycated hemoglobin (HbA1c) levels in a real-world setting in Japanese patients with type 2 diabetes. We also investigated age at death.

Methods: This historical cohort study included 1582 patients with type 2 diabetes who first visited our clinic from 1995 to 1998 and continued visiting for at least 1 year. The patients were followed up through 2017. Blood glucose levels at 2 h ± 30 min post-breakfast (2h-PBBG) were measured in 926 patients during the first year. The first measurements of 2h-PBBG levels were used as a measure of postprandial hyperglycemia.

Results: A total of 233 patients died. The average age at death (men/women) was 75.6/80.8 years. A total of 139 patients who had 2h-PBBG levels measured died, including 46 deaths from cancer. Multivariate Cox regression analysis showed that 2h-PBBG levels significantly predicted all-cause and cancer mortality independent of HbA1c levels.

Conclusions: Postprandial hyperglycemia at clinic visits may be associated with all-cause and cancer mortality in patients with type 2 diabetes independent of HbA1c levels. As this is a small observational study, further studies are warranted to confirm our findings.

Keywords: All-cause mortality; Cancer mortality; Clinic visit; Postprandial hyperglycemia; Type 2 diabetes.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care / statistics & numerical data
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Cause of Death
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / mortality*
  • Female
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / complications
  • Hyperglycemia / mortality*
  • Japan / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neoplasms / blood*
  • Neoplasms / complications
  • Neoplasms / mortality*
  • Postprandial Period / physiology

Substances

  • Blood Glucose
  • Glycated Hemoglobin A