A recent study by Karim Kohansal and team showed that among males fasting blood sugar variability only the conversion to type 2 diabetes (T2DM) was associated with an elevated risk of all-cause mortality, whereas in women, the impaired fasting sugar status whether incident, chronic, or converted to T2DM impacted the mortality.

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The findings of this study were published in Cardiovascular Diabetology.

Fasting plasma sugar testing is frequently used in clinical practice to identify type 2 diabetes and pre-diabetes since it is less expensive and time-consuming than other methods and is readily accessible. There are notable sex disparities in the morbidity- and mortality-related consequences of T2DM, according to mounting research. In order to examine the sex-specific effects of short-term alterations in FPG status on the long-term risk of all-cause, CV, and cancer mortality in persons without T2DM at baseline, researchers employed pooled analysis of three significant cohort studies. Additionally, we wanted to investigate how short-term FPG alterations affected mortality occurrences in men versus women.
14,378 individuals (30–60 years old; 8272 women) from three population-based cohort studies, including Tehran Lipid and Glucose Study, Multi-Ethnic Study of Atherosclerosis, and Atherosclerosis Risk in Communities, made up the study population. Based on the roughly three-year changes in FPG status, subjects were divided into six groups: normal FPG (NFG) to NFG (reference category); NFG to impaired fasting glucose (IFG); NFG to T2DM; IFG to NFG; IFG to IFG; and IFG to T2DM. To estimate hazard ratios (HRs (95% CI)) for all-cause and cause-specific mortality events, multivariable stratified Cox regression with adjustments for age, body mass index (BMI), BMI-Change, smoking status, hypertension, and hypercholesterolemia was employed. For each category, estimated women-to-men HR ratios (RHRs) were calculated.

The key findings of this study were:
2,362 all-cause death occurrences were noted during the follow-up period.
In comparison to the NFG-NFG group, all FPG change categories in women, with the exception of IFG-NFG, were linked to a greater risk of all-cause death.
Additionally, women in the IFG-T2DM group had a higher risk of cardiovascular death. Additionally, researchers discovered that women in the NFG-IFG and IFG-IFG groups had a greater chance of dying from cancer.
However, only two groups of males with NFG-T2DM and IFG-T2DM were shown to have a greater risk of all-cause death.
In comparison to males, women with IFG-IFG had a 24% greater risk of all-cause death events.
Results were consistent with the main findings after further physical activity adjustment, eliminating T2DM up to six years after the survey period and early death events.
Reference:
Kohansal, K., Masrouri, S., Khalili, D., Ramezankhani, A., Azizi, F., Blaha, M. J., & Hadaegh, F. (2022). Changes in Fasting plasma glucose status and risk of mortality events in individuals without diabetes over two decades of Follow-up: a pooled cohort analysis. In Cardiovascular Diabetology (Vol. 21, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12933-022-01709-z