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Fasting glucose variability in young adulthood and incident diabetes, cardiovascular disease and all-cause mortality.

Publication ,  Journal Article
Bancks, MP; Carson, AP; Lewis, CE; Gunderson, EP; Reis, JP; Schreiner, PJ; Yano, Y; Carnethon, MR
Published in: Diabetologia
August 2019

AIMS/HYPOTHESIS: The aim of this study was to determine whether long-term intra-individual variability in fasting glucose (FG) during young adulthood is associated with incident diabetes, cardiovascular disease (CVD) and mortality. METHODS: We included participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study, ages 18-30 years at baseline (1985-1986) and followed with eight examinations for up to 30 years. Long-term glucose variability was assessed using the CV (CV-FG) and the absolute difference between successive FG measurements (average real variability; ARV-FG). For participants who developed any event (diabetes, CVD or mortality), FG variability measurement was censored at the examination prior to event ascertainment. We estimated HRs for incident diabetes, CVD and mortality with adjustment for demographics, baseline FG, change in FG (censor - baseline) and time-varying education, smoking, alcohol consumption, BMI, physical activity, systolic BP, BP medications, LDL-cholesterol and cholesterol medications (and incident diabetes and diabetes medications for CVD and mortality outcomes). RESULTS: Among 3769 black and white participants, there were 317 incident diabetes cases (102,677 person-years), 159 incident CVD events (110,314 person-years) and 174 deaths (111,390 person-years). After adjustment, HRs per 1 SD higher ARV-FG were 1.64 (95% CI 1.52, 1.78) for diabetes, 1.15 (95% CI 1.01, 1.31) for CVD and 1.25 (95% CI 1.11, 1.40) for mortality. The HRs per 1 SD higher CV-FG were 1.39 (95% CI 1.21, 1.58) for diabetes, 1.32 (95% CI 1.13, 1.54) for CVD and 1.08 (95% CI 0.92, 1.27) for mortality, after adjustment. The cause-specific HRs per 1 SD higher ARV-FG were 1.29 (95% CI 1.14, 1.47) for non-CVD death and 1.05 (95% CI 0.76, 1.45) for CVD death. We did not observe evidence for effect modification of any association by sex or race. CONCLUSIONS/INTERPRETATION: Our results suggest that higher intra-individual FG variability during young adulthood before the onset of diabetes is associated with incident diabetes, CVD and mortality.

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Published In

Diabetologia

DOI

EISSN

1432-0428

Publication Date

August 2019

Volume

62

Issue

8

Start / End Page

1366 / 1374

Location

Germany

Related Subject Headings

  • Young Adult
  • White People
  • United States
  • Risk Factors
  • Proportional Hazards Models
  • Multivariate Analysis
  • Mortality
  • Middle Aged
  • Male
  • Longitudinal Studies
 

Citation

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ICMJE
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Bancks, M. P., Carson, A. P., Lewis, C. E., Gunderson, E. P., Reis, J. P., Schreiner, P. J., … Carnethon, M. R. (2019). Fasting glucose variability in young adulthood and incident diabetes, cardiovascular disease and all-cause mortality. Diabetologia, 62(8), 1366–1374. https://doi.org/10.1007/s00125-019-4901-6
Bancks, Michael P., April P. Carson, Cora E. Lewis, Erica P. Gunderson, Jared P. Reis, Pamela J. Schreiner, Yuichiro Yano, and Mercedes R. Carnethon. “Fasting glucose variability in young adulthood and incident diabetes, cardiovascular disease and all-cause mortality.Diabetologia 62, no. 8 (August 2019): 1366–74. https://doi.org/10.1007/s00125-019-4901-6.
Bancks MP, Carson AP, Lewis CE, Gunderson EP, Reis JP, Schreiner PJ, et al. Fasting glucose variability in young adulthood and incident diabetes, cardiovascular disease and all-cause mortality. Diabetologia. 2019 Aug;62(8):1366–74.
Bancks, Michael P., et al. “Fasting glucose variability in young adulthood and incident diabetes, cardiovascular disease and all-cause mortality.Diabetologia, vol. 62, no. 8, Aug. 2019, pp. 1366–74. Pubmed, doi:10.1007/s00125-019-4901-6.
Bancks MP, Carson AP, Lewis CE, Gunderson EP, Reis JP, Schreiner PJ, Yano Y, Carnethon MR. Fasting glucose variability in young adulthood and incident diabetes, cardiovascular disease and all-cause mortality. Diabetologia. 2019 Aug;62(8):1366–1374.
Journal cover image

Published In

Diabetologia

DOI

EISSN

1432-0428

Publication Date

August 2019

Volume

62

Issue

8

Start / End Page

1366 / 1374

Location

Germany

Related Subject Headings

  • Young Adult
  • White People
  • United States
  • Risk Factors
  • Proportional Hazards Models
  • Multivariate Analysis
  • Mortality
  • Middle Aged
  • Male
  • Longitudinal Studies