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Glycemic Variability and Risk of CV Events Assessed

Diabetes Care; ePub 2019 Jan 18; Echouffo-Tcheugui, et al

Greater visit-to-visit variability (VVV) of fasting blood glucose (FBG) is associated with increased mortality risk, according to a recent study. Researchers conducted a prospective cohort analysis including 4,982 participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) who attended the baseline, 24-month, and 48-month visits. Participants free of cardiovascular disease (CVD) during the first 48 months of the study were followed for incident CVD (coronary heart disease [CHD], stroke, and heart failure [HF]) and all-cause mortality. They found:

  • Over a median follow-up of 5 years, there were 305 CVD events (189 CHD, 45 stroke, and 81 HF) and 154 deaths.
  • The adjusted hazard ratio (HR) comparing participants in the highest vs lowest quartile of SD of FBG (≥26.4 vs <5.5) was 1.43 for CVD and 2.22 for all-cause mortality.
  • HR for VIM was 1.17 for CVD and 1.89 for all-cause mortality.
  • Among individuals without diabetes, the highest quartile of SD of FBG (HR 2.67) or VIM (HR 2.50) conferred a higher risk of death.

Echouffo-Tcheugui JB, Zhao S, Brock G, Matsouaka RA, Kline D, Joseph JI. Visit-to-visit glycemic variability and risks of cardiovascular events and all-cause mortality: The ALLHAT Study. [Published online ahead of January 18, 2019]. Diabetes Care. doi:10.2337/dc18-1430.