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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1449925
This article is part of the Research Topic Cardiovascular Diseases Related to Diabetes and Obesity - Volume V View all 17 articles

Traditional versus Intensive Blood Glucose Control: Long-term Target Range Duration and Cardiovascular Disease Risk and All-cause Mortality -A Real-world Cohort Study

Provisionally accepted
Jingdi Zhang Jingdi Zhang 1*Liuxin Li Liuxin Li 2Donglei Luo Donglei Luo 3Zhenyu Huo Zhenyu Huo 1Xiaoxue Zhang Xiaoxue Zhang 2Yiran Xu Yiran Xu 1Jingyuan Jiang Jingyuan Jiang 2Tiantian Liu Tiantian Liu 2Shouling Wu Shouling Wu 4Zhe Huang Zhe Huang 4
  • 1 College of Public Health, North China University of Science and Technology, Tangshan, China
  • 2 North China University of Science and Technology, Tangshan, Hebei Province, China
  • 3 Department of Cardiology, Chengde Central Hospital, Chengde, China
  • 4 Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei Province, China

The final, formatted version of the article will be published soon.

    Objective: For a long time, the dispute about whether improved glycemic control can bring significant benefits has remained unresolved. We aimed to investigate the association of time spent in different fasting glucose target ranges with cardiovascular risk and all-cause mortality in a population with type 2 diabetes (T2DM).Method: A total of 3460 T2DM patients in the Kailuan cohort were included in this study. The Time in Target Range (TITRE) was calculated as the proportion of time that fasting blood glucose (FBG) was within the usual glycemic control range and the intensive glycemic control range between 2006 and 2016. The Cox proportional hazards regression model analyzed the relationship between TITRE, defined by different glucose ranges, and cardiovascular disease and all-cause mortality.Results: During a median follow-up of 4.23 years, a total of 360 CVDs and 238 deaths were recorded. After correcting for traditional risk factors, we observed that in the conventional blood glucose control group, each increase of 1 standard deviation in TITRE was associated with a 23% (HR, 0.77; 95%CI, 0.68-0.87) reduction in CVD risk and a 20% reduction in all-cause mortality (HR, 0.80; 95%CI, 0.69-0.92). Similar results were also observed in the intensified blood glucose control group. In the conventional blood glucose control group, participants with TITRE of 50% or more had an absolute incidence rate of CVD of 16.77%, whereas in the intensified blood glucose control group, participants with TITRE of 50% or more had an absolute incidence rate of CVD of 11.82%.In patients with type 2 diabetes, achieving near-normal blood glucose levels appears to significantly reduce the risk of diabetes-related cardiovascular outcomes.

    Keywords: Fasting blood glucose, time in range, diabetes, cardiovascular outcomes, Legacy effect

    Received: 16 Jun 2024; Accepted: 22 Nov 2024.

    Copyright: © 2024 Zhang, Li, Luo, Huo, Zhang, Xu, Jiang, Liu, Wu and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jingdi Zhang, College of Public Health, North China University of Science and Technology, Tangshan, China

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