Diabetes, Vol 48, Issue 4 896-902, Copyright © 1999 by American Diabetes Association

ARTICLES

Effect of glycemia on mortality in Pima Indians with type 2 diabetes

ML Sievers, PH Bennett and RG Nelson
Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Arizona 85014-4972, USA.

The effect of plasma glucose concentration on overall and cause-specific mortality was examined in 1,745 Pima Indians (725 men, 1,020 women) > or = 15 years old with type 2 diabetes. During a median follow-up of 10.6 years (range 0.1-24.8), 533 subjects (275 men, 258 women) died; 113 of the deaths were attributable to cardiovascular disease, 96 to diabetes-related diseases (diabetic nephropathy for 92 of these), 249 to other natural causes, and 75 to external causes. After adjusting for age, sex, duration of diabetes, and BMI in a generalized additive proportional hazards model, higher baseline 2-h postload plasma glucose concentration predicted deaths from cardiovascular disease (P = 0.007) and diabetes-related diseases (P = 0.003), but not from other natural causes (P = 0.73). An increment of 5.6 mmol/l (100 mg/dl) in the 2-h plasma glucose concentration was associated with 1.2 times (95% CI 1.1-1.4) the death rate from cardiovascular disease, 1.3 times (95% CI 1.1-1.5) the death rate from diabetes-related diseases, and almost no change in the death rate from other natural causes (rate ratio = 1.0; 95% CI 0.94-1.1). In Pima Indians with type 2 diabetes, higher plasma glucose concentration predicts deaths from cardiovascular and diabetes-related diseases but has little or no effect on deaths from other natural or external causes.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A. Shankar, R. Klein, B. E. K. Klein, and S. E. Moss Association between Glycosylated Hemoglobin Level and Cardiovascular and All-Cause Mortality in Type 1 Diabetes Am. J. Epidemiol., August 15, 2007; 166(4): 393 - 402. [Abstract] [Full Text] [PDF]

				J. Xu, S. Eilat-Adar, C. M Loria, B. V Howard, R. R Fabsitz, M. Begum, E. M Zephier, and E. T Lee Macronutrient intake and glycemic control in a population-based sample of American Indians with diabetes: the Strong Heart Study Am. J. Clinical Nutrition, August 1, 2007; 86(2): 480 - 487. [Abstract] [Full Text] [PDF]

				R. T. Goins, S. M. Spencer, Y. D. Roubideaux, and S. M. Manson Differences in Functional Disability of Rural American Indian and White Older Adults With Comorbid Diabetes Research on Aging, November 1, 2005; 27(6): 643 - 658. [Abstract] [PDF]

				C. Wilson, S. Gilliland, T. Cullen, K. Moore, Y. Roubideaux, L. Valdez, W. Vanderwagen, and K. Acton Diabetes Outcomes in the Indian Health System During the Era of the Special Diabetes Program for Indians and the Government Performance and Results Act Am J Public Health, September 1, 2005; 95(9): 1518 - 1522. [Abstract] [Full Text] [PDF]

				R. Scognamiglio, C. Negut, S. V. De Kreutzenberg, A. Tiengo, and A. Avogaro Postprandial Myocardial Perfusion in Healthy Subjects and in Type 2 Diabetic Patients Circulation, July 12, 2005; 112(2): 179 - 184. [Abstract] [Full Text] [PDF]

				S. J. Rith-Najarian, D. M. Gohdes, R. Shields, B. Skipper, K. R. Moore, B. Tolbert, T. Raymer, and K. J. Acton Regional Variation in Cardiovascular Disease Risk Factors Among American Indians and Alaska Natives With Diabetes Diabetes Care, February 1, 2002; 25(2): 279 - 283. [Abstract] [Full Text] [PDF]

				E. Bonora, F. Calcaterra, S. Lombardi, N. Bonfante, G. Formentini, R. C. Bonadonna, and M. Muggeo Plasma Glucose Levels Throughout the Day and HbA1c Interrelationships in Type 2 Diabetes: Implications for treatment and monitoring of metabolic control Diabetes Care, December 1, 2001; 24(12): 2023 - 2029. [Abstract] [Full Text] [PDF]

				J. S. Carter, S. S. Gilliland, G. E. Perez, B. Skipper, and F. D. Gilliland Public Health and Clinical Implications of High Hemoglobin A1c Levels and Weight in Younger Adult Native American People With Diabetes Arch Intern Med, December 11, 2000; 160(22): 3471 - 3476. [Abstract] [Full Text] [PDF]

				M. L. Sievers, P. H. Bennett, J. Roumain, and R. G. Nelson Effect of Hypertension on Mortality in Pima Indians Circulation, July 6, 1999; 100(1): 33 - 40. [Abstract] [Full Text] [PDF]