High blood sugar, triglycerides after meal may signal mortality risk in T2D

In patients with type 2 diabetes (T2D), postprandial hyperglycaemia and hypertriglyceridemia worsens survival outlook, finds a new study.

The study included 1,928 T2D patients with ≥1 year of follow-up information. Two-hour post-breakfast blood glucose (2h-BG) was measured in 1,122 patients, and postprandial serum triglyceride (ppTG) was quantified in 1,826. The primary endpoint was all-cause mortality, but the researchers also sought to determine threshold values for the assessment of death risk.

Over 17,429 person-years of follow-up in the BG cohort, 162 deaths were reported. In comparison, the TG cohort was followed for 28,026 person-years, during which 253 deaths occurred. The resulting crude incidence rates were 9.29 and 9.03 events per 1,000 person-years, respectively.

Multivariate Cox regression analysis showed that across quintiles of 2h-BG and ppTG, all-cause mortality risk varied significantly. That is, the top vs bottom quintile of 2h-BG (hazard ratio [HR], 2.37, 95 percent confidence interval [CI], 1.26–4.47; p_trend=0.034) and ppTG (HR, 1.63, 95 percent CI, 1.03–2.60; p_trend=0.007), the risk of all-cause mortality was significantly higher.

Even when taking both blood markers as continuous variables, the researchers saw the link to death risk. Each standard deviation increase in 2h-BG (HR, 1.34, 95 percent CI, 1.08–1.67) and ppTG (HR, 1.24, 95 percent CI, 1.06–1.45) led to a significant spike in all-cause mortality risk. These interactions remained significant even when controlling for medications.

Kaplan-Meier curves identified threshold 2h-BG and ppTG threshold values of 13.8 and 2.30 mmol/L, respectively. Patients who fell beyond these cut-offs showed increasingly greater all-cause mortality risk after 2 and 5 years of follow-up, respectively.