Sang-Wook Yi1,2, Sangkyu Park3, Yong-Ho Lee4, Beverley Balkau5, Jee-Jeon Yi6. 1. Department of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea flyhigh@cku.ac.kr. 2. Institute for Clinical and Translational Research, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea. 3. Department of Biochemistry, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea. 4. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 5. Center for Research in Epidemiology and Population Health, Team 5 (Team EpReC: Renal and cardiovascular Epidemiology), INSERM U-1018, Villejuif, France. 6. Institute for Occupational and Environmental Health, Catholic Kwandong University, Gangneung, Republic of Korea.
Abstract
OBJECTIVE: To examine associations between fasting glucose and mortality and to identify the levels associated with lowest mortality by age in diabetes. RESEARCH DESIGN AND METHODS: A total of 359,645 Korean adults with known prevalent diabetes participated in health screening during 2001-2004 and were followed up until 2013. RESULTS: U-curve associations were found. Fasting glucose levels associated with the lowest mortality were ∼90-130 mg/dL, except for in those aged 18-44 years (∼80-95 mg/dL). Multivariable-adjusted hazard ratios of fasting glucose <65, 65-74, 75-84, 140-169, 170-199, and ≥200 mg/dL were 1.46, 1.12, 1.09, 1.12, 1.31, and 1.78, respectively, compared with 85-99 mg/dL. CONCLUSIONS: Optimal fasting glucose range for survival is higher in adults with than without known prevalent diabetes, except, perhaps, younger adults. Tight glucose control may lessen premature death in younger adults with diabetes. Hypoglycemia (<65 mg/dL) was associated with higher mortality than was fasting glucose 170-199 mg/dL, while fasting glucose 65-84 mg/dL had risks comparable with those at levels 140-169 mg/dL in diabetes.
OBJECTIVE: To examine associations between fasting glucose and mortality and to identify the levels associated with lowest mortality by age in diabetes. RESEARCH DESIGN AND METHODS: A total of 359,645 Korean adults with known prevalent diabetes participated in health screening during 2001-2004 and were followed up until 2013. RESULTS: U-curve associations were found. Fasting glucose levels associated with the lowest mortality were ∼90-130 mg/dL, except for in those aged 18-44 years (∼80-95 mg/dL). Multivariable-adjusted hazard ratios of fasting glucose <65, 65-74, 75-84, 140-169, 170-199, and ≥200 mg/dL were 1.46, 1.12, 1.09, 1.12, 1.31, and 1.78, respectively, compared with 85-99 mg/dL. CONCLUSIONS: Optimal fasting glucose range for survival is higher in adults with than without known prevalent diabetes, except, perhaps, younger adults. Tight glucose control may lessen premature death in younger adults with diabetes. Hypoglycemia (<65 mg/dL) was associated with higher mortality than was fasting glucose 170-199 mg/dL, while fasting glucose 65-84 mg/dL had risks comparable with those at levels 140-169 mg/dL in diabetes.
Authors: EunKyo Kang; Kyae Hyung Kim; Young Min Cho; Sang Min Park; Yong-Jin Kim; Hae-Young Lee; Ye Eun Rhee; Soojeong Kim; Young Ho Yun Journal: Int J Behav Med Date: 2020-11-10