OBJECTIVE To examine associations between fasting glucose and mortality and to identify the levels associated with lowest mortality by age in diabetes.

RESEARCH DESIGN AND METHODS A total of 359,645 Korean adults with known prevalent diabetes participated in health screening during 2001–2004 and were followed up until 2013.

RESULTS U-curve associations were found. Fasting glucose levels associated with the lowest mortality were ∼90–130 mg/dL, except for in those aged 18–44 years (∼80–95 mg/dL). Multivariable-adjusted hazard ratios of fasting glucose <65, 65–74, 75–84, 140–169, 170–199, and ≥200 mg/dL were 1.46, 1.12, 1.09, 1.12, 1.31, and 1.78, respectively, compared with 85–99 mg/dL.

CONCLUSIONS Optimal fasting glucose range for survival is higher in adults with than without known prevalent diabetes, except, perhaps, younger adults. Tight glucose control may lessen premature death in younger adults with diabetes. Hypoglycemia (<65 mg/dL) was associated with higher mortality than was fasting glucose 170–199 mg/dL, while fasting glucose 65–84 mg/dL had risks comparable with those at levels 140–169 mg/dL in diabetes.

目的探讨空腹血糖与死亡率之间的关系，并确定与糖尿病患者最低死亡率相关的水平。

研究设计与方法2001年至2004年间，共有359,645名韩国已知流行糖尿病成人参加了健康筛查，并一直随访至2013年。

结果发现了U型曲线关联。空腹血糖水平与最低死亡率相关，约为18-44岁（约80-95 mg / dL），约为90-130 mg / dL。空腹血糖<65、65-74、75-84、140-169、170-199和≥200mg / dL的多变量调整的危险比分别为1.46、1.12、1.09、1.12、1.31和1.78含85–99 mg / dL。

结论患有糖尿病的成年人的最佳空腹血糖范围要比没有已知流行糖尿病的成年人高，除了可能是年轻的成年人。严格的血糖控制可以减少年轻的糖尿病成年人的过早死亡。与空腹血糖170–199 mg / dL相比，低血糖（<65 mg / dL）与较高的死亡率相关，而空腹血糖65–84 mg / dL的危险与糖尿病中140–169 mg / dL的危险相当。