Diabetes Metab J.  2014 Feb;38(1):44-50. 10.4093/dmj.2014.38.1.44.

Plasma Glucose Regulation and Mortality in Korea: A Pooled Analysis of Three Community-Based Cohort Studies

• Kim NH
• Kim DJ
• Park SW
• Oh JY
• Park JY
• Shin C
• Lee HK
• Park Y
• Committee on the Epidemiology of Diabetes Mellitus, Korean Diabetes Association

• KMID: 2174184
• DOI: http://doi.org/10.4093/dmj.2014.38.1.44

Abstract

BACKGROUND
Although diabetes is a well-known risk factor for death, its impact on cancer death is not clearly understood. Furthermore, it remains controversial whether impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are associated with increased risk of mortality. We investigated the impact of diabetes or glucose tolerance categories on all cause and cause-specific mortality.
METHODS
Mortality analysis was conducted in three population-based cohort studies of 3,801 participants, divided according to fasting plasma glucose (FPG) (normal; stage 1 IFG [5.6< or =FPG<6.1 mmol/L]; stage 2 IFG [6.1< or =FPG<7.0 mmol/L]; diabetes mellitus [DM]-FPG); or 2-hour glucose after 75 g glucose loading (2hPG) (normal; IGT; DM-2hPG), or a combination of FPG and 2hPG criteria.
RESULTS
During a median follow-up of 11.0 years, 474 subjects died from all causes. Hazard ratios (HRs) for all cause death were higher in those with diabetes as defined by either FPG or 2hPG criteria than their normal counterparts (HR, 2.2, 95% confidence interval [CI], 1.6 to 2.9 for DM-FPG; HR, 2.0, 95% CI, 1.5 to 2.7 for DM-2hPG). Similarly, diabetes defined by either FPG or 2hPG was associated with cancer death (HR, 2.9, 95% CI, 1.7 to 5.0; and HR, 2.1, 95% CI, 1.2 to 3.9, respectively). Although neither IFG nor IGT conferred higher risk for death, when combining stage 2 IFG and/or IGT, the risk of all cause death was higher than in subjects with normal glucose regulation (HR, 1.3; 95% CI, 1.0 to 1.6).
CONCLUSION
Diabetes is associated with higher risk of death from all causes and cancer. In subjects without diabetes, stage 2 IFG and/or IGT confers increased risk for mortality.

Keyword

Diabetes mellitus; Glucose intolerance; Mortality

MeSH Terms

Blood Glucose*
Cohort Studies*
Diabetes Mellitus
Fasting
Follow-Up Studies
Glucose
Glucose Intolerance
Korea*
Mortality*
Plasma*
Risk Factors
Glucose

Figure

• 

  Fig. 1 Hazard ratios and 95% confidence interval (CI) of death from all causes, cancer, and cardiovascular disease (CVD) according to glucose categories by fasting plasma glucose and 2-hour glucose after 75 g glucose loading criteria. Prediabetes was defined as (A) impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), or (B) stage 2 IFG and/or IGT. NRG, normal glucose regulation; DM, diabetes mellitus.

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