Long-term glucose variability and risk of nephropathy complication in UKPDS, ACCORD and VADT trials.

Individual de­identified participant data of ACCORD was requested through BioLINCC (https://biolincc.nhlbi.nih.gov/home/). The independent scientific review board reviewed and approved the request. The study protocols are available on ClinicalTrials.gov. VADT and UKPDS deidentified participant data will not be available online, but upon request. Action to Control Cardiovascular Risk in Diabetes Fasting blood glucose Fasting plasma glucose Residual absolute real variability Residual standard deviation UK Prospective Diabetes Study Veteran Affairs Diabetes Trial Zoungas S, Arima H, Gerstein HC et al (2017) Effects of intensive glucose control on microvascular outcomes in patients with type 2 diabetes: a meta-analysis of individual participant data from randomised controlled trials. Lancet Diabetes Endocrinol 5(6):431–437. https://doi.org/10.1016/S2213-8587(17)30104-3. Article PubMed Google Scholar Hirakawa Y, Arima H, Zoungas S et al (2014) Impact of visit-to-visit glycemic variability on the risks of macrovascular and microvascular events and all-cause mortality in type 2 diabetes: the ADVANCE trial. Diabetes Care 37(8):2359–2365. https://doi.org/10.2337/dc14-0199 CAS Article PubMed Google Scholar UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352(9131):837–853. https://doi.org/10.1016/S0140-6736(98)07019-6 Article Google Scholar The Action to Control Cardiovascular Risk in Diabetes Study Group (2008) Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 358(24):2545–2559. https://doi.org/10.1056/NEJMoa0802743 Article PubMed Central Google Scholar Duckworth W, Abraira C, Moritz T et al (2009) Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med 360(2):129–139. https://doi.org/10.1056/NEJMoa0808431 CAS Article PubMed Google Scholar Ismail-Beigi F, Craven T, Banerji MA et al (2010) Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial. Lancet 376(9739):419–430. https://doi.org/10.1016/S0140-6736(10)60576-4. Diaz KM, Tanner RM, Falzon L et al (2014) Visit-to-visit variability of blood pressure and cardiovascular disease and all-cause mortality: a systematic review and meta-analysis. Hypertension 64(5):965–982. https://doi.org/10.1161/HYPERTENSIONAHA.114.03903. Gorst C, Kwok CS, Aslam S et al (2015) Long-term glycemic variability and risk of adverse outcomes: a systematic review and meta-analysis. Diabetes Care 38(12):2354–2369. https://doi.org/10.2337/dc15-1188 CAS Article PubMed Google Scholar Download references The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. This work was supported by the Veterans Affairs Cooperative Studies Program, Department of Veterans Affairs Office of Research and Development. Additional support was received from the National Institutes of Health R01-067690 and 5R01- 094775 to PR, and the American Diabetes Association to PR. JJZ is supported by the NIH grant K01DK106116 and an Arizona Biomedical Research Centre (ABRC) new investigator award. RRH is an emeritus UK National Institute for Health Research Senior Investigator. Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA Jin J. Zhou Carl T. Hayden Phoenix VA Health Care System (111E), Phoenix, AZ, USA Jin J. Zhou & Peter Reaven Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK Ruth Coleman & Rury R. Holman You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar JJZ and PR conceived the idea. JJZ conducted the analysis and drafted the manuscript. RC and RRH provided UKPDS data. PR provided VADT data. All authors helped to interpret the data and write the manuscript. JJZ is the guarantor of this work. All authors provided final approval of the version to be published. Correspondence to Jin J. Zhou. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. (PDF 281 kb) Reprints and Permissions Zhou, J.J., Coleman, R., Holman, R.R. et al. Long-term glucose variability and risk of nephropathy complication in UKPDS, ACCORD and VADT trials. Diabetologia (2020). https://doi.org/10.1007/s00125-020-05273-7 Download citation Received: 27 May 2020 Accepted: 29 July 2020 Published: 21 September 2020 DOI: https://doi.org/10.1007/s00125-020-05273-7