Growing evidences shows that fasting glucose target should be different according to their health condition in older adults with diabetes. However, there are limited data regarding the relationship between fasting glucose level and health outcomes in Korean older people with diabetes. We aimed to examine the association of fasting glucose with mortality and cardiovascular events in Korean older adults with type 2 diabetes. From the Korean National Health Insurance System, 227,938 subjects (aged ≥ 65 years) with type 2 diabetes but no history of cardiovascular events (myocardial infarction or stroke) who underwent ≥ 2 health examinations from 2009 to 2010 and who were followed up until 2017 were identified. The primary exposure variable was the mean fasting glucose level. We estimated the relationship between the baseline fasting glucose level and incidences of all-cause death and cardiovascular events. Comorbidity load was assessed using the Charlson comorbidity index. Fasting glucose levels and all-cause mortality risk showed a J-shaped relationship regardless of sex and number of comorbidities. Fasting glucose levels associated with the lowest mortality and cardiovascular events were 110–124 and 95–124 mg/dL, respectively. Stratified analysis by comorbidity load using the Charlson comorbidity index revealed higher optimal fasting glucose levels for the lowest cardiovascular events in subjects with Charlson comorbidity index ≥ 3 than in those with Charlson comorbidity index ≤ 2 (119 vs. 112 mg/dL, P = 0.04). J-shaped relationship existed between fasting glucose and all-cause mortality and cardiovascular events in Korean older adults with diabetes. We identified that fasting glucose levels associated with the lowest mortality and cardiovascular events were 110–124 and 95–124 mg/dL respectively. Increased risk of cardiovascular events with low fasting glucose level (< 95 mg/dL) was noted, especially in patients with high comorbidity. These findings suggested that less stringent targets of fasting glucose may be beneficial especially in older adults with multiple comorbidities.

中文翻译：

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最重要的一点是：老年糖尿病患者的空腹血糖，心血管疾病和死亡率：一项基于全国人群的研究。

越来越多的证据表明，根据糖尿病患者的健康状况，空腹血糖指标应有所不同。但是，有关韩国老年人糖尿病患者空腹血糖水平与健康结局之间关系的数据有限。我们旨在检查空腹血糖与韩国2型糖尿病老年人死亡率和心血管事件的相关性。根据韩国国家健康保险系统的规定，从2009年至2010年接受≥2次健康检查并随访至2017年的227,938名2型糖尿病受试者（≥65岁）没有心血管事件（心肌梗塞或中风）的病史。确定。主要暴露变量是平均空腹血糖水平。我们估计了基线空腹血糖水平与全因死亡和心血管事件发生率之间的关系。使用查尔森合并症指数评估合并症负荷。空腹血糖水平和全因死亡率风险呈J型关系，而与性别和合并症数量无关。与最低死亡率和心血管事件相关的空腹血糖水平分别为110-124和95-124 mg / dL。使用Charlson合并症指数对合并症负荷进行的分层分析显示，Charlson合并症指数≥3的受试者中最低心血管事件的最佳空腹血糖水平高于Charlson合并症指数≤2的受试者（119 vs.112 mg / dL，P = 0.04 ）。在韩国老年糖尿病患者中，空腹血糖与全因死亡率和心血管事件之间存在J型关系。我们确定与最低死亡率和心血管事件相关的空腹血糖水平分别为110-124 mg / dL和95-124 mg / dL。空腹血糖水平低（<95 mg / dL）的心血管事件风险增加，特别是合并症高的患者。这些发现表明，空腹血糖较严格的指标可能有益，尤其是在患有多种合并症的老年人中。注意到95 mg / dL），尤其是合并症高的患者。这些发现表明，空腹血糖较严格的指标可能是有益的，尤其是在患有多种合并症的老年人中。注意到95 mg / dL），尤其是合并症高的患者。这些发现表明，空腹血糖较严格的指标可能是有益的，尤其是在患有多种合并症的老年人中。