Brief report The effects of fasting plasma glucose variability and time-dependent glycemic control on the long-term risk of retinopathy in type 2 diabetic patients Toshiko Takao a, *, Takehiko Ide a , Hiroyuki Yanagisawa b , Masatoshi Kikuchi a , Shoji Kawazu a , Yutaka Matsuyama c a Division of Metabolic Diseases, The Institute for Adult Diseases, Asahi Life Foundation, 1-6-1 Marunouchi, Chiyoda-ku, Tokyo 100-0005, Japan b Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan c Department of Biostatistics School of Public Health University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan 1. Introduction The association between glucose variability and the complica- tions of diabetes has been extensively reviewed [1–5], but whether glucose variability in addition to the mean plasma glucose/HbA1c level is a predictor of microangiopathy remains to be clarified. It has been suggested that results differ between short- and long-term glucose variability [1]. The Diabetic Control and Complications Trial/Epidemiolo- gy of Diabetes Interventions and Complications (DCCT/EDIC) and the United Kingdom Prospective Diabetic Study (UKPDS) are two landmark trials which show that the benefits of good glycemic control continue beyond the study period in people with type 1 and type 2 diabetes [6,7]. This effect has been termed the metabolic memory or legacy effect. To clarify whether fasting plasma glucose (FPG) variability can predict the development of proliferative diabetic reti- nopathy (PDR) independently of glycemic control, we per- formed a long-term follow-up study in people with type 2 diabetes. In addition, the association between glycemic diabetes research and clinical practice 91 (2011) e 40– e 42 article info Article history: Received 12 September 2010 Received in revised form 24 September 2010 Accepted 4 October 2010 Published on line 29 October 2010 Keywords: Glucose variability Time-dependent glycemic control Long-term Retinopathy Type 2 diabetes abstract Long-term fasting plasma glucose (FPG) variability was a risk factor for proliferative diabetic retinopathy (PDR) independent of the mean FPG or HbA1c in people with type 2 diabetes. PDR development was also significantly associated with mean HbA1c more than 5 years earlier and with mean FPG more than 10 years earlier. # 2010 Elsevier Ireland Ltd. All rights reserved. * Corresponding author. Tel.: +81 3 32016781; fax: +81 3 32016881. E-mail addresses: t-takao@asahi-life.or.jp, toshiko@qc4.so-net.ne.jp (T. Takao). Contents lists available at ScienceDirect Diabetes Research and Clinical Practice journal homepage: www.elsevier.com/locate/diabres 0168-8227/$ – see front matter # 2010 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.diabres.2010.10.009