Table 2.
Association of measures of glucose variability over a mean of 6.5 years of quarterly follow-up in the DCCT with progression of complications
| Adjusted for mean blood glucose* |
||||
|---|---|---|---|---|
| Hazard ratio | 95% CL | Z value | P value† | |
| Retinopathy | ||||
| Within-day | ||||
| SD | 0.937 | 0.834, 1.054 | −1.08 | 0.28 |
| MAGE | 0.938 | 0.837, 1.050 | −1.11 | 0.27 |
| M-value | 0.804 | 0.582, 1.112 | −1.32 | 0.19 |
| Longitudinal | ||||
| Total blood glucose variance | 0.951 | 0.844, 1.072 | −0.83 | 0.41 |
| Between-day variance | 0.920 | 0.839, 1.009 | −1.76 | 0.08 |
| Within-day variance | 0.970 | 0.872, 1.080 | −0.55 | 0.59 |
| Mean MAGE | 0.966 | 0.853, 1.095 | −0.54 | 0.60 |
| Mean M-value | 0.972 | 0.792, 1.191 | −0.28 | 0.79 |
| Microalbuminuria | ||||
| Within-day | ||||
| SD | 1.021 | 0.842, 1.238 | 0.21 | 0.84 |
| MAGE | 1.01 | 0.834, 1.213 | 0.062 | 0.96 |
| M-value | 0.899 | 0.517, 1.564 | −0.38 | 0.71 |
| Longitudinal | ||||
| Total blood glucose variance | 1.084 | 0.838, 1.401 | 0.61 | 0.54 |
| Between-day variance | 1.132 | 0.999, 1.283 | 1.95 | 0.06 |
| Within-day variance | 0.904 | 0.698, 1.172 | −0.76 | 0.45 |
| Mean MAGE | 0.812 | 0.621, 1.062 | −1.52 | 0.13 |
| Mean M-value | 2.142 | 1.505, 3.048 | 4.23 | <0.0001 |
| Odds ratio | ||||
|---|---|---|---|---|
| Cardiovascular autonomic neuropathy | ||||
| Within-day | ||||
| SD | 1.098 | 0.952, 1.268 | 1.29 | 0.20 |
| MAGE | 1.138 | 0.999, 1.298 | 1.93 | 0.06 |
| M-value | 1.336 | 0.953, 1.874 | 1.68 | 0.10 |
| Longitudinal | ||||
| Total blood glucose variance | 1.357 | 1.114, 1.655 | 3.03 | 0.0025 |
| Between-day variance | 1.221 | 1.052, 1.416 | 2.63 | 0.0087 |
| Within-day variance | 1.132 | 0.946, 1.355 | 1.35 | 0.18 |
| Mean MAGE | 1.155 | 0.925, 1.444 | 1.27 | 0.21 |
| Mean M-value | 1.011 | 0.690, 1.483 | 0.06 | 0.96 |
*Models for the association of within-day measures of variation with the risk of progression of microvascular complications are also adjusted for the within-day mean blood glucose; models for longitudinal measures of variation are adjusted for the longitudinal mean level of blood glucose. The hazard ratio is from a Cox proportional hazards model of the incidence of retinopathy and nephropathy progression over time, and the odds ratio is from a general estimating equation logistic regression model of prevalence of CAN at 2, 4, 6, and 8 years of follow-up.
The association of all measures with progression of complications without adjustment for the mean blood glucose is shown in the Supplementary Data. CL, confidence limits.
†After applying the Holm procedure to correct for the total of 24 tests, only the effect of the mean M-value on risk of microalbuminuria (Z = 4.23) meets the criteria for significance at the 0.05 level.