Association between time in range and cancer mortality among patients with type 2 diabetes: a prospective cohort study.
10.1097/CM9.0000000000001740
- Author:
Yun SHEN
1
;
Chunfang WANG
2
;
Yaxin WANG
3
;
Jingyi LU
1
;
Lei CHEN
2
;
Lei ZHANG
1
;
Wei LU
1
;
Wei ZHU
1
;
Gang HU
4
;
Tian XIA
2
;
Jian ZHOU
1
Author Information
1. Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China.
2. Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.
3. Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
4. Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
- Publication Type:Journal Article
- MeSH:
Blood Glucose;
Blood Glucose Self-Monitoring;
China;
Diabetes Mellitus, Type 2/complications*;
Humans;
Neoplasms;
Prospective Studies
- From:
Chinese Medical Journal
2021;135(3):288-294
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Little was known about the association among time in range (TIR), time above range (TAR), time below range (TBR), and cancer mortality among patients with type 2 diabetes. We aimed to investigate the association among TIR, TAR, TBR, and the risk of cancer mortality among patients with type 2 diabetes.
METHODS:A total of 6225 patients with type 2 diabetes were prospectively recruited in Shanghai, China. TIR was measured with continuous glucose monitoring at baseline and was defined as the average percentage of time in the target glucose range during a 24 h period. Cox proportion hazard regression analysis was used to determine the association between TIR and the risk of cancer mortality.
RESULTS:During a mean follow-up of 7.10 years, we confirmed 237 death events related to cancer. The multivariable-adjusted hazard ratio (HR) for cancer mortality was 1.32 (95% confidence interval [CI]: 1.01-1.75) in patients with TIR ≤70% compared with those with TIR >70%. When TIR was considered as a continuous variable, the multivariable-adjusted HR for cancer mortality associated with each 10% decrease in TIR was 1.07 (95% CI: 1.02-1.14). In the site-specific analysis, a significant association between TIR as a continuous variable and the risk of hepatocellular cancer was found (HR: 1.24; 95% CI: 1.09-1.41). However, no relationship between hemoglobin A1c and cancer mortality was observed (HR: 1.04; 95% CI: 0.97-1.10).
CONCLUSIONS:The present study found an inverse association of TIR with the risk of cancer mortality among patients with type 2 diabetes. New evidence of TIR was added into the clinical practice that TIR may be an optimal target of glycemic control among patients with type 2 diabetes.
