Relationship between blood glucose level and mortality in Type 2 diabetes mellitus: a systematic review

Abstract

Aim To review the relationship between blood glucose level and mortality in patients with Type 2 diabetes mellitus (DM) as reported in the literature. for papers were: Type 2 DM; follow-up for at least 3 years; glucose or glycated haemoglobin (HbA 1c ) was used as parameter; published in the form of an article. Additionally all references in the selected articles that dealt with the relationship between blood glucose level and mortality in Type 2 DM were included in the search.Results Twenty-seven eligible articles were found. Twenty-three of them showed a positive association: measures of elevated blood glucose concentrations were associated with higher mortality; in 15 out of 23 studies the positive association was statistically signi®cant, in two only for postprandial blood glucose. One study found a nonsigni®cant negative relationship in a very old population. ConclusionIn the literature there is a positive, but rather weak, association between the measures of blood glucose control and the risk of dying of patients with Type 2 DM. In the six larger studies (more than 100 deceased patients) that used a continuous categorization of glycaemia, the Risk ratio per unit varies from 1.03 to 1.12. Diabet. Med. 16, 2±13 (1999)

Risk factors for cardiovascular mortality and morbidity: The WHO multinational study of vascular disease in diabetes.

“…For the patients with Type II diabetes in our study, fasting plasma glucose was a predictor for all cardiovascular end-points, including stroke, and its association with CVD mortality was independent of all other variables (Model 3). A recent systematic review found that 23 out of 27 prospective studies in Type II diabetic patients showed a positive association between poor glycaemic control and either total or CVD mortality [54].…”

Ethnic and Racial Differences in Diabetes Care

“…Despite these baseline similarities and equal likelihood of receiving treatment, African Americans and Hispanics had significantly worse control of hypertension and African Americans had worse control of diabetes. This poor control is especially worrisome in light of research that demonstrates that poor glucose control contributes to the risk of micro-and macrovascular complications and mortality (15)(16)(17)(18). Poorly controlled hypertension has been reported in one study to be the strongest predictor of the development of coronary heart disease in people with diabetes (19).…”

Effectiveness of Fenugreek for Lowering Hemoglobin (HbA1c) in Patients with Self-Management of Type 2 Diabetes: A Randomized Controlled Trial

“…Table 6. Effect of Fenugreek on Hemoglobin (HbA1c) in type 2 diabetes In patients with type 2 diabetes previous studies have shown an association between the degree of hyperglycemia and increased risk of microvascular complications (Klein, 1995), sensory neuropathy (Alder et al 1997), myocardial infarction (Klein, 1995;UKPDS,1998), stroke (Lehto et al 1996), macrovascular mortality (Groeneveld et al 1999) and all cause mortality (Wei et al 1998;Knuiman et al 1992). Generally, these studies measured glycemia as being high or low or assessed glycemia on a single occasion, whereas repeated measurements of glycemia over several moths or year would be more informative.…”