Impact of postprandial hyperglycemia at clinic visits on the incidence of cardiovascular events and all‐cause mortality in patients with type 2 diabetes

Abstract

Aims/IntroductionWe evaluated the impact of postprandial hyperglycemia at clinic visits on the incidence of cardiovascular diseases (CVD) and all‐cause mortality independently of mean glycosylated hemoglobin in type 2 diabetes patients in a real‐world setting.Materials and MethodsThe present retrospective observational cohort study included 646 type 2 diabetes patients. All of the participants had their initial consultations at the Institute for Diabetes Care and Research, Asahi Life Foundation affiliated Marunouchi Hospital, Tokyo, Japan, during the period from 1995 to 1996, visited the clinic ≥4 times, had their 2‐h post‐breakfast blood glucose (2h‐PBBG) levels measured and were followed up for ≥1 year. The 646 patients were followed up for survival. Of the 646 patients, 618 had no history of CVD at the first visit and had measured 2h‐PBBG until the first CVD onset or censorings. These two cohorts were followed up through June 2012, and subsequently questionnaires were mailed. Multivariate Cox proportional hazard models were used to evaluate the risk of CVD incidence and death.Results CVD occurred in 78 patients, and 56 patients died. The median follow‐up periods of the CVD cohort and the mortality cohort were 15.6 and 15.9 years, respectively. The mean 2h‐PBBG is a significant predictor of the CVD incidence and all‐cause mortality after adjusting for the mean glycosylated hemoglobin, the number of 2h‐PBBG measurements, age, sex and classical risk factors.ConclusionsPostprandial hyperglycemia represented by the mean level of 2h‐PBBG at clinic visits is associated with CVD incidence and all‐cause mortality independently of the mean glycosylated hemoglobin level in type 2 diabetes patients. Prospective interventional trials are warranted to confirm the present findings.

Prevalence and Predictors of Home Use of Glucometers in Diabetic Patients

“…This finding is significant because a previous study suggests that postprandial hyperglycemia confers an increased risk of cardiovascular disease and death [28] and a low incidence of this practice is worrisome. As already mentioned in the American Diabetic Association guidelines [14], we also observed that people with a low frequency of SMBG failed to adjust their treatment regimens.…”

“…In accordance with Parkin C, et al [ 27 ], we found that a majority of the participants who used glucometers monitored their fasting blood glucose alone while failing to monitor postprandial glucose. This finding is significant because a previous study suggests that postprandial hyperglycemia confers an increased risk of cardiovascular disease and death [ 28 ] and a low incidence of this practice is worrisome. As already mentioned in the American Diabetic Association guidelines [ 14 ], we also observed that people with a low frequency of SMBG failed to adjust their treatment regimens.…”

Impact of a Usual Serving Size of Flavanol-Rich Cocoa Powder Ingested with a Diabetic-Suitable Meal on Postprandial Cardiometabolic Parameters in Type 2 Diabetics—A Randomized, Placebo-Controlled, Double-Blind Crossover Study

“…The prevalence of type 2 diabetes (T2D) is increasing globally [ 1 ]. In patients with T2D, postprandial hyperglycemia has shown to raise the incidence of cardiovascular disease (CVD) and all-cause mortality [ 2 , 3 ]. Postprandial hyperglycemia is often accompanied by postprandial hypertriglyceridemia, which acts as a further risk factor for CVD.…”

Effect of postprandial hyperglycemia at clinic visits on the incidence of retinopathy in patients with type 2 diabetes: An analysis using real‐world long‐term follow‐up data

“…Clinical examinations and laboratory methods used in the present study have been described previously. To summarize, blood samples were collected regardless of fasting or postprandial status.…”