1520-P: All-Cause Mortality in Chinese Adults with Diabetes in Association with New Indicator Generated by the 2-h Plasma Glucose Level Subtract Fasting Plasma Glucose Level

Background and Aims: Reducing the increased risk of death among diabetes patients is highly valued in regard to quality care of diabetes. We aim to identify practical indicator to estimate the hazard of all-cause mortality for Chinese population with diabetes.

Method: The Chinese Chronic Disease and Risk Factor Surveillance 2010 (CCDRF) selected a national representative sample of Chinese population aged ≥18 years using a multistage sampling design. CCDRF included a mortality follow-up by December 2018. A retrospective cohort of 10,388 Chinese subjects who diagnosed as diabetes was selected. Indicator ‘2hPG-FBG’ was created using 2-h Plasma Glucose Level (2hPG) of the OGTT subtract fasting plasma glucose (FBG) level for each individual. Subjects were classified into four groups (2hPG-FBG <=0, 0-4, 4-10, and >10 mmol/l). The Kaplan-Meier curve with log rank test and multivariate Cox proportional regression were employed to assess the group differences.

Results: A total of 10,388 participants were included, with 53.8% male and mean age 52.2 years. During the 8-year follow-up, 292 subject dead. Kaplan-Meier curves comparing the four groups showed significant differences (p <.01). After adjusting for age, sex, smoking status, alcohol drinking and FBG, compared to group whose 2hPG≤ FBG, the hazard of the group (2hPG-FBG 0-4mmol/l) is similar but slight elevated (adjusted hazard ratio [AHR]=1.5; 95% CI, 0.9-2.4; p=0.11); the hazards are significantly higher for group (2hPG-FBG 4-10 mmol/l) (AHR= 2.0; 95% CI, 1.3-3.1; p<0.01) and for group (2hPG-FBG >10 mmol/l)(AHR=2.6; 95% CI, 1.6-4.3; p <0.01).

Conclusions: The hazard of all-cause mortality doubled among Chinese population with diabetes whose 2hPG-FBG higher than 4 mmol/l, compared to those whose 2hPG≤ FBG.

Public health significant: Personalized target of 2hPG may be set based on patients’ FBG to reduce the increased risk of death among adults with diabetes.