Long-term variability of glycemic markers and risk of all-cause mortality in type 2 diabetes: A systematic review and meta-analysis
Rattachement africain : ir, ru. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Abstract Background & aims This research aimed to assess how long-term fluctuations in glycemic indicators (FPG and HbA1c), measured by the coefficient of variation (CV), influence the risk of all-cause mortality in people with type 2 diabetes. Methods A review of all literature related to the variability of glycemic indicators published up to June 2025 was conducted using PubMed, Scopus, and Google Scholar. A total of 3,663 articles were found and evaluated based on the title, introduction, and full text, leading to the selection of 15 studies for the meta-analysis. Meta-analysis was performed using a random-effects model. Subgroup and meta-regression analyses were used to explore sources of heterogeneity. Results Fifteen studies ( n = 584,237) were included. Higher glycemic variability was generally linked to increased mortality risk, but this connection showed extreme statistical heterogeneity (I² >85% for both HbA1c-CV and FPG-CV). Therefore, single pooled estimates (e.g., HR: 0.39 for HbA1c-CV) were unreliable and required stratified interpretation; initial inverse associations were corrected after harmonizing effect coding (Table S1). Importantly, meta-regression revealed that cohort mean age was the strongest moderator, explaining nearly 48.3% (R² = 48.3%) of the between-study heterogeneity. The prognostic link was notably stronger in younger populations, suggesting a diminished effect in older adults due to competing risks. Sensitivity analyses confirmed the consistency of the overall effect direction. Conclusions Long-term glycemic variability is linked to all-cause mortality in type 2 diabetes. Given the extreme heterogeneity, our findings emphasize that age strongly modifies the risk estimates, suggesting that GV is a more potent prognostic marker in younger T2DM populations. Clinically, potential monitoring of GV should be highly individualized and considered hypothesis-generating, particularly in high-risk, younger subgroups. Standardization of metrics and further prospective studies are warranted.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Long-term variability of glycemic markers and risk of all-cause mortality in type 2 diabetes: A systematic review and meta-analysis
- Date Crossref
- 03/12/2025
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Guilan University of Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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University of Guilan pays non établi dans la noticeUniversité ou école supérieure
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Kazan Federal University pays non établi dans la noticeUniversité ou école supérieure
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Mashhad University of Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Isfahan University of Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Islamic Azad University Medical Branch of Tehran Tehran Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Tehran University of Medical Sciences Tehran Heart Center pays non établi dans la noticeUniversité ou école supérieure
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Qazvin University of Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Shiraz University of Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Iran University of Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Shahid Beheshti University of Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Zanjan University of Medical Sciences pays non établi dans la noticeUniversité ou école supérieure
Guilan University of Medical Sciences, University of Guilan et Kazan Federal University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.