The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index; none of the 45 sources its claims cite is checked for support yet.
Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
Abstract
OBJECTIVE: The influence of postprandial blood glucose on diabetes complications is intensively debated. We aimed to evaluate the predictive role of both fasting and postprandial blood glucose on cardiovascular events in type 2 diabetes and the influence of gender. METHODS: In a population of 529 (284 men and 245 women) consecutive type 2 diabetic patients attending our diabetes clinic, we evaluated the relationships, corrected for cardiovascular risk factors and type of treatment, between cardiovascular events in a 5-yr follow-up and baseline values of hemoglobin A1c (HbA1c) and blood glucose measured: 1) after an overnight fast, 2) after breakfast, 3) after lunch, and 4) before dinner. Continuous variables were categorized into tertiles. RESULTS: We recorded cardiovascular events in 77 subjects: 54 of 284 men (19%) and 23 of 245 women (9.4%). Univariate analysis indicated that cardiovascular events were associated with increasing age, longer diabetes duration, and higher HbA1c and fibrinogen in men, and higher systolic blood pressure, albumin excretion rate, HbA1c, and all blood glucose values in women. Smoking was more frequent in subjects with events. When all blood glucose values and HbA1c were introduced simultaneously in the models, only blood glucose after lunch predicted cardiovascular events, with hazard ratio of the third tertile vs. the first and the second tertiles greater in women (5.54; confidence interval, 1.45-21.20) than in men (2.12; confidence interval, 1.04-4.32; P < 0.01). CONCLUSIONS: Postprandial, but not fasting, blood glucose is an independent risk factor for cardiovascular events in type 2 diabetes, with a stronger predictive power in women than in men, suggesting that more attention should be paid to postprandial hyperglycemia, particularly in women.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
In a 5-year follow-up of 529 type 2 diabetes patients, blood glucose measured after lunch independently predicted cardiovascular events, whereas fasting glucose did not. The predictive effect was stronger in women than in men.
Key findings
- Cardiovascular events occurred in 77 participants: 54 of 284 men (19%) and 23 of 245 women (9.4%).
- When all glucose measurements and HbA1c were included together, only post-lunch blood glucose remained a significant predictor of cardiovascular events.
- The hazard ratio for the third tertile versus the first and second tertiles of post-lunch glucose was 5.54 (95% CI, 1.45–21.20) in women and 2.12 (95% CI, 1.04–4.32) in men; the gender difference was statistically significant (P < 0.01).
- HbA1c correlated with all measured glucose values in both genders, but fasting glucose had low predictive value for events.
Methods
- Prospective cohort study of 529 consecutive type 2 diabetes patients at an Italian diabetes clinic, enrolled in 1995 and followed through 2000.
- Baseline assessment included cardiovascular risk factors, HbA1c, and glucose profiles: fasting, 2 hours after breakfast, 2 hours after lunch, and before dinner.
- Cox proportional hazards models were fitted separately by gender, with glucose and HbA1c values categorized into tertiles and adjusted for age, diabetes duration, previous cardiovascular events, systolic blood pressure, albumin excretion rate, fibrinogen, smoking, and type of treatment.
Limitations
- The paper states that a possible limitation is the limited number of cardiovascular events in women.
- The text makes evident that glucose before lunch was unavailable for most patients, so lunch-induced glucose excursions could not be evaluated across the whole cohort.
- Glucose profiles were measured either in hospital by nurses or at home by patients using a reflectance meter, which may introduce measurement variability.
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Claims the paper makes
28 Own result · 25 Not checked yet · 10 Own interpretation · 5 Own method · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In men, when models were fitted with single BG values (models A-D) and the third tertile was compared with the first and the second tertiles, a significantly increased risk of cardiovascular events was observed only for BGAL.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“BG after breakfast predicted cardiovascular events in the DIS, but not in our study”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When all blood glucose values and HbA1c were introduced simultaneously in the models, only blood glucose after lunch predicted cardiovascular events”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The blood glucose profiles used at baseline reflect the patients' usual glycemic control.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When all BG values were considered together, only HR for BGAL remained statistically significant both without and with the addition of HbA1c in the models (model E and J).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Men without and with cardiovascular events differed for age, known diabetes duration, previous cardiovascular events, fibrinogen, and HbA1c”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, when all BG values were added together and with HbA1c, the risk for men in the third tertile of BGAL was twice that for subjects in the other tertiles (model J).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The effect of hypoglycemic treatment was not significant when men and women were considered separately or pooled together.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Actually, HbA1c values, incorporating information derived from both preand postprandial BG, were higher in men and women developing events.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In our study, cardiovascular events were much more frequent in men”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, in patients developing cardiovascular events, the differences between BG values after lunch and after breakfast (which underestimate the after lunch glycemic increases) are greater than those in patients not developing events”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 19
- Probably not a substantial claim. 27
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In women, when each BG value was considered independently of the others (models A-D), HR for FBG, BGAL, and BGBD were significant; the results were confirmed when HbA1c was included in the models (models F-I).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“HbA1c was correlated ( P < 0.0001) with all BG values in both men and women.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When HbA1c and BG values from both genders were pooled together, multiple regression analysis showed that all values remained significantly correlated with HbA1c (r = 0.104, P < 0.046 for FBG; r = 0.216, P < 0.0001 for BGAB; r = 0.229, P < 0.0001 for BGAL; and r = 0.097, P = 0.049 for BGBD).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“women differed for previous cardiovascular events, systolic blood pressure, AER, HbA1c, and all BG”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Men and women differed significantly for age, diabetes duration, previous cardiovascular events, smoking habit, hypoglycemic therapy, BMI, total/HDL cholesterol ratio, fibrinogen, AER, and HbA1c.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“38 of 77 (49.3%) were coronary (29 in men and nine in women), 26 of 77 (33.8%) were cerebrovascular (14 in men and 12 in women), and 13 of 77 (16.9%) were peripheral vascular (11 in men and two in women).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Rests on an assumption: Record linkage with hospital discharge and population registers accurately identifies cardiovascular events and deaths.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Twenty-three participants died: five from cardiovascular events, 10 from neoplasia, and eight from other reasons; death was preceded by a cardiovascular event in two subjects who died from neoplasia or other causes.”
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Rests on an assumption: Record linkage with hospital discharge and population registers accurately identifies cardiovascular events and deaths.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We recorded cardiovascular events in 77 patients, 54 in 284 men (19%) and 23 in 245 women (9.4%)”
plainn = 77- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: Record linkage with hospital discharge and population registers accurately identifies cardiovascular events and deaths.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When both men and women were pooled together, the effect of smoking habit was significant ( 𝛘 2 = 7.8; P = 0.02).”
- Also stated in: § First Published Online December 13, 2005 · plain
“Smoking was more frequent in subjects with events.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § First Published Online December 13, 2005 · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“BGAL was higher than BGAB ( P = 0.02 in men and P = 0.007 in women; Table 1), with greater differences in patients with events (Table 2).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“linear correlation coefficients between HbA1c and FBG, BGAB, BGAL, and BGBD were, respectively, in men, r = 0.388, r = 0.425, r = 0.483, and r = 0.390; and in women, r = 0.452, r = 0.512, r = 0.458, and r = 0.421.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with hazard ratio of the third tertile vs. the first and the second tertiles greater in women (5.54; confidence interval, 1.45-21.20) than in men (2.12; confidence interval, 1.04-4.32; P < 0.01).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The blood glucose profiles used at baseline reflect the patients' usual glycemic control.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In model J, HR for BGAL was greater in women (5.54; confidence interval, 1.45-21.20) than in men (2.12; confidence interval, 1.04-4.32; for the difference between genders, P < 0.01).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The association of cardiovascular events with BGAL remained significant when all BG values were added together (model E) or when HbA1c was added (model H).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“whereas men presented a more frequent smoking habit, greater total/HDL cholesterol ratio and AER, and a more frequent history of previous cardiovascular events.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In contrast, when we tried to determine the predictive role of each component of BG control, we observed a low predictive value of FBG and HbA1c, in agreement with other observations concerning the prediction of atherosclerosis in subjects at risk for type 2 diabetes mellitus (33).”
What the sources say
- Not checked yetcites [33] 33. Temelkova-Kurktschiev T, Koehler C, Henkel E, Leonhardt W, Fuecker K, Hanefeld M 2000 Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose or HbA1c level. Diabetes Care 23:1830-1834
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“women were older, had a longer diabetes duration, and had greater BMI, HbA1c and fibrinogen values”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In particular, HR for cardiovascular events conferred by postlunch BG was 5.54 in women vs. 2.12 in men, the difference being statistically significant.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“predicts the incidence of cardiovascular events and mortality more than fasting BG”
What the sources say
- Not checked yetcites [13] 13. Haffner S 1998 The importance of hyperglycemia in the non fasting state to the development of cardiovascular disease. Endocr Rev 19:583-592
- Not checked yetcites [14] 14. Bonora E, Muggeo M 2001 Postprandial blood glucose as a risk factor for cardiovascular disease in type 2 diabetes: the epidemiological evidence. Diabetologia 44:2107-2114
- Not checked yetcites [15] 15. Heine RJ, Dekker JM 2002 Beyond postprandial hyperglycaemia: metabolic factors associated with cardiovascular disease. Diabetologia 45:461-475
- Not checked yetcites [16] 16. Gerich JE 2003 Clinical significance, pathogenesis and management of postprandial hyperglycemia. Arch Intern Med 163:1306-1316
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“the reflectance meter used both in the hospital and at home was Reflolux II (Roche, Mannheim, Germany), whose reliability in our laboratory has been previously described (27).”
What the sources say
- Not checked yetcites [27] 27. Trovati M, Burzacca S, Mularoni E, Massucco P, Cavalot F, Mattiello L, Anfossi G 1991 Occurrence of low blood glucose concentrations during the afternoon in type 2 (non-insulin-dependent) diabetic patients on oral hypoglycaemic agents: importance of blood glucose monitoring. Diabetologia 34:662-667
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The main messages of this paper are that BG after lunch predicts the occurrence of cardiovascular events in a 5-yr follow-up in type 2 diabetic patients more than fasting BG, and that this effect is stronger in women than in men.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“P ATIENTS AFFECTED BY type 2 diabetes show an increased cardiovascular morbidity and mortality (1, 2).”
What the sources say
- Not checked yetcites [1] 1. Laakso M, Lehto S 1997 Epidemiology of macrovascular disease in diabetes. Diabetes Rev 5:294-315
- Not checked yetcites [2] 2. Stamler J, Vaccaro O, Necton JD, Wentworth D, for the Multiple Risk Factor Intervention Trial Risk Group 1993 Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 16:434-444
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In a study carried out on diet-treated type 2 diabetic patients, we showed that BG values before lunch were significantly lower than BG measured 2 h after breakfast (31).”
What the sources say
- Not checked yetcites [31] 31. Trovati M, Ponziani MC, Massucco P, Anfossi G, Mularoni EM, Burzacca S, - Tassone F, Perna P, Traversa M, Cavalot F 2002 Blood glucose pre-prandial baseline decreases from morning to evening in type 2 diabetes: role of fasting blood glucose and influence on post-prandial excursions. Eur J Clin Invest 32:179-186
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“BG after breakfast, but not fasting BG, has been found to predict myocardial infarction and mortality in newly diagnosed type 2 diabetic patients (11).”
What the sources say
- Not checked yetcites [11] 11. Hanefeld M, Fischer S, Julius U, Schulze J, Schwanebeck U, Schmechel H, Ziegelasch HJ, Lindner J 1996 Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11-year follow-up. Diabetologia 39:1577-1583
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“whereas other studies do not show significant gender-related differences (6).”
What the sources say
- Not checked yetcites [6] 6. de Vegt F, Dekker JM, Ruhe HG, Stehouwer CD, Nijpels G, Bouter LM, HeineRJ 1999 Hyperglycaemia is associated with all-cause and cardiovascular mortality in the Hoorn population: the Hoorn study. Diabetologia 42:926-931
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“A relationship between BG control and cardiovascular events has also been observed in type 2 diabetic patients (10-12).”
What the sources say
- Not checked yetcites [10] 10. Laakso M 1999 Hyperglycemia and cardiovascular disease in type 2 diabetes. Diabetes 48:937-942
- Not checked yetcites [11] 11. Hanefeld M, Fischer S, Julius U, Schulze J, Schwanebeck U, Schmechel H, Ziegelasch HJ, Lindner J 1996 Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11-year follow-up. Diabetologia 39:1577-1583
- Not checked yetcites [12] 12. Standl E, Balletshofer B, Dahl B, Weichenhain B, Stiegler H, Hormann A, Holle R 1996 Predictors of 10-year macrovascular and overall mortality in patients with NIDDM: the Munich General Practitioner Project. Diabetologia 39:1540-1545
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Postprandial, but not fasting, blood glucose is an independent risk factor for cardiovascular events in type 2 diabetes”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The blood glucose profiles used at baseline reflect the patients' usual glycemic control.
In the paper
“BG after breakfast predicted cardiovascular events in the DIS, but not in our study”
What the sources say
- Not checked yetcites [11] 11. Hanefeld M, Fischer S, Julius U, Schulze J, Schwanebeck U, Schmechel H, Ziegelasch HJ, Lindner J 1996 Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11-year follow-up. Diabetologia 39:1577-1583
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“As we described in a previous study, in type 2 diabetes the BG baseline on which postmeal excursions are superimposed (what we called the preprandial baseline) is not stable as it is in nondiabetic subjects, but decreases from morning to evening, probably because of waning of the early morning increase in counterregulatory hormones (31).”
What the sources say
- Not checked yetcites [31] 31. Trovati M, Ponziani MC, Massucco P, Anfossi G, Mularoni EM, Burzacca S, - Tassone F, Perna P, Traversa M, Cavalot F 2002 Blood glucose pre-prandial baseline decreases from morning to evening in type 2 diabetes: role of fasting blood glucose and influence on post-prandial excursions. Eur J Clin Invest 32:179-186
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“postprandial and postload glucose concentrations should be kept clearly distinct (17).”
What the sources say
- Not checked yetcites [17] 17. Yudkin JS 2002 Post-load hyperglycaemia-an inappropriate therapeutic target. Lancet 359:166-167
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Assumption of proportionality of hazards was tested using the log cumulative hazard plot, that is, the plot of log ( -log [S(t)]) vs. log of survival time, where S(t) represents the survival function.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Thus, because postprandial excursions are superimposed to a falling preprandial BG baseline, glycemic profiles look rather flat in our patients (31).”
What the sources say
- Not checked yetcites [31] 31. Trovati M, Ponziani MC, Massucco P, Anfossi G, Mularoni EM, Burzacca S, - Tassone F, Perna P, Traversa M, Cavalot F 2002 Blood glucose pre-prandial baseline decreases from morning to evening in type 2 diabetes: role of fasting blood glucose and influence on post-prandial excursions. Eur J Clin Invest 32:179-186
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“In the general population, cardiovascular mortality rate is two to five times greater in men than in women (19, 20).”
What the sources say
- Not checked yetcites [19] 19. Jackson R, Chambless L, Higgins M, Kuulasmaa K, Wijnberg L, Williams D 1997 WHO Monica Project, and ARIC Study sex difference in ischaemic heart disease mortality and risk factors in 46 communities: an ecologic analysis. Cardiovasc Risk Factors 7:43-54
- Not checked yetcites [20] 20. Jousilahti P, Vartiainen E, Tuomilehto J, Puska P 1999 Sex, age, cardiovascular risk factors, and coronary heart disease: a prospective follow-up study of 14786 middle-aged men and women in Finland. Circulation 99:1165-1172
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“in the year 2000, the follow-up was completed for 484 patients (91.4%).”
plainn = 484- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Residual analysis was conducted using log-cumulative hazard plots of Cox-Snell residuals to ascertain the adequacy of linear prediction in the Cox models.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, because only a minority of our patients measured BG before lunch, we could not evaluate the lunch-induced BG excursions in all of the cohort.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“this apparent discrepancy is not surprising because of the striking differences between the caloric and carbohydrate contents of breakfast in Germany and that in northwestern Italy.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: In Piedmont, breakfast is frequently a virtual meal consisting only of a cup of coffee and sometimes a small piece of bread.
None of the sources cited for this claim have been checked yet.
In the paper
“Some meta-analyses state that hyperglycemia is a stronger cardiovascular risk factor in women than in men (22, 23)”
What the sources say
- Not checked yetcites [22] 22. Orchard TJ 1996 The impact of gender and general risk factors on the occurrence of atherosclerotic vascular disease in non-insulin-dependent diabetes mellitus. Ann Med 28:323-333
- Not checked yetcites [23] 23. Lee WL, Cheung AM, Cape D, Zinman B 2000 Impact of diabetes on coronary artery disease in women and men: a meta-analysis of prospective studies. Diabetes Care 23:962-968
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“whereas other state that gender-related differences disappear after adjustment for the main cardiovascular risk factors (24).”
What the sources say
- Not checked yetcites [24] 24. Kanaya AM, Grady D, Barrett-Connor E 2002 Explaining the sex difference in coronary heart disease mortality among patients with type 2 diabetes mellitus: a meta-analysis. Arch Intern Med 162:1737-1745
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Acarbose also reduced the risk of myocardial infarction in type 2 diabetic patients (35)”
What the sources say
- Not checked yetcites [35] 35. Hanefeld M, Cagatay M, Petrowitsch T, Neuser D, Petzinna D, Rupp M 2004 - Acarbose reduces the risk for myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studies. Eur Heart J 25:10-16
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“and slowed the progression of intima media thickness of carotid arteries in subjects with impaired glucose tolerance (36).”
What the sources say
- Not checked yetcites [36] 36. Hanefeld M, Chiasson JL, Koehler C, Henkel E, Schaper F, TemelkovaKurktschiev T 2004 Acarbose slows progression of intima-media thickness of the carotid arteries in subjects with impaired glucose tolerance. Stroke 35: 1073-1078
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
No prior study has examined whether sex affects the predictive value of postprandial glucose in patients with established type 2 diabetes.
“As far as we know, no study addressed the influence of gender in the predictive power of postprandial (not postchallenge) BG in patients with an established diagnosis of type 2 diabetes.”
The paper relies on this without support.
The blood glucose profiles used at baseline reflect the patients' usual glycemic control.
“To get BG values truly reflecting the real glycemic control, we considered BG profiles available for clinical purposes at the routine visit in which the cardiovascular risk factors and HbA1c were measured”
The paper relies on this without support.
Record linkage with hospital discharge and population registers accurately identifies cardiovascular events and deaths.
“An individual record linkage with the hospital discharge database of the Piedmont region ( ∼ 4,200,000 inhabitants), the region in northwest Italy that includes Turin (the capital, with about 1,000,000 inhabitants), was conducted”
“An individual record linkage using the individual fiscal code as the key linkage was conducted with the Turin historical population register”
The paper relies on this without support.
The clinic-based cohort is representative of patients with type 2 diabetes generally.
“In a population of 529 (284 men and 245 women) consecutive type 2 diabetic patients attending our diabetes clinic”
The paper relies on this without support.
In Piedmont, breakfast is frequently a virtual meal consisting only of a cup of coffee and sometimes a small piece of bread.
“Actually, breakfast in the Piedmont is frequently a virtual meal, consisting only of a cup of coffee with, sometimes, a small piece of bread.”
The paper relies on this without support.
Hypoglycemic drugs are usually given in the morning.
“because hypoglycemic drugs are usually given in the morning”
The paper relies on this without support.
The differences between blood glucose after lunch and after breakfast underestimate the after-lunch glycemic increases.
“(which underestimate the after lunch glycemic increases)”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Post-prandial dysmetabolism is an independent predictor of future cardiovascular events even in nondiabetic individuals.”
From Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health (2008) · cites this paper as [8]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Continuous linear direct relationships exist between glucose levels after a glucose challenge and the risks of both CV death and all-cause mortality (8).”
From Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health (2008) · cites this paper as [8]
Experimental — accuracy not yet measuredIn the citing paper
“The adverse impact of post-prandial or post-challenge (OGTT) hyperglycaemia seems to be even stronger than that of fasting hyperglycaemia [5][6][7][8][9].”
From Prevalence and correlates of post-prandial hyperglycaemia in a large sample of patients with type 2 diabetes mellitus (2006) · cites this paper as [7]
Citations
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Metadata
- Authors
- Cavalot, F., Petrelli, A., Traversa, M., Bonomo, K., Fiora, E., Conti, M., Anfossi, G., Costa, G., & Trovati, M.
- Affiliations
- Ospedale San Luigi Gonzaga (IT)
- University of Turin (IT)
- Corresponding author
- Trovati, M.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2006-03
- Volume
- 91
- Issue
- 3
- Pages
- 813-819
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1967633321
- Cited by
- 569
- References
- 34
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 16 · 2023: 26 · 2022: 22 · 2021: 22 · 2020: 34 · 2019: 27 · 2018: 31 · 2017: 33 · 2016: 37 · 2015: 35 · 2014: 37 · 2013: 27 · 2012: 40
- FWCI
- 21.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- postprandial blood glucose, fasting blood glucose, type 2 diabetes, cardiovascular events, cardiovascular risk prediction, sex differences, postprandial hyperglycemia, HbA1c
- MeSH terms
- Aged, Blood Glucose, Blood Pressure, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Fasting, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Sex Characteristics, Biomarkers, Body Mass Index, Postprandial Period
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-27, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-27 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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