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Aims/Introduction  We evaluated the impact of postprandial hyperglycemia at clinic visits on the incidence of cardiovascular diseases ( CVD ) and all‐cause mortality independently of mean glycosylated hemoglobin in type 2 diabetes patients in a real‐world setting.    Materials and Methods  The present retrospective observational cohort study included 646 type 2 diabetes patients. All of the participants had their initial consultations at the Institute for Diabetes Care and Research, Asahi Life Foundation affiliated Marunouchi Hospital, Tokyo, Japan, during the period from 1995 to 1996, visited the clinic ≥4 times, had their 2‐h post‐breakfast blood glucose (2h‐ PBBG ) levels measured and were followed up for ≥1 year. The 646 patients were followed up for survival. Of the 646 patients, 618 had no history of  CVD  at the first visit and had measured 2h‐ PBBG  until the first  CVD  onset or censorings. These two cohorts were followed up through June 2012, and subsequently questionnaires were mailed. Multivariate Cox proportional hazard models were used to evaluate the risk of  CVD  incidence and death.    Results   CVD  occurred in 78 patients, and 56 patients died. The median follow‐up periods of the  CVD  cohort and the mortality cohort were 15.6 and 15.9 years, respectively. The mean 2h‐ PBBG  is a significant predictor of the  CVD  incidence and all‐cause mortality after adjusting for the mean glycosylated hemoglobin, the number of 2h‐ PBBG  measurements, age, sex and classical risk factors.    Conclusions  Postprandial hyperglycemia represented by the mean level of 2h‐ PBBG  at clinic visits is associated with  CVD  incidence and all‐cause mortality independently of the mean glycosylated hemoglobin level in type 2 diabetes patients. Prospective interventional trials are warranted to confirm the present findings.

journal of diabetes investigation

Impact of postprandial hyperglycemia at clinic visits on the incidence of cardiovascular events and all‐cause mortality in patients with type 2 diabetes