Influence of Fasting Glucose Levels on Achieving Glycemic Target in Individuals with Type 2 Diabetes: a Post Hoc Analysis

Abstract

FPG GOAL was a 24-week, open-label, treat-to-target randomized controlled trial which demonstrated that the optimal self-monitored fasting blood glucose (SM-FBG) target for most Chinese individuals with type2 diabetes (T2D) using insulin glargine 100IU/mL was 3.9-6.1mmol/L. Individuals who achieved lower fasting plasma glucose (FPG) levels might achieve the target HbA1c of < 7% without increasing the risk of hypoglycemia. For this post hoc analysis, individuals were redivided into three groups based on their actual laboratory FPG levels at 24weeks: level1, ≤ 5.6mmol/L; level2, > 5.6 to ≤ 6.1mmol/L; and level3, > 6.1 to ≤ 7.0mmol/L. At week24, 863 individuals with diabetes had available FPG data and 179, 122, and 179 individuals achieved FPG levels1, 2, and 3, respectively. The proportion of individuals with HbA1c < 7% or HbA1c < 7% without hypoglycemia (≤ 3.9 or ≤ 3.0mmol/L) was significantly higher in FPG levels1 (p < 0.01) and 2 (p < 0.05) than in level3. The least squares mean changes from baseline in HbA1c (- 1.77% and - 1.66% vs - 1.34%; both p < 0.001) and 2-h postprandial glucose (- 3.88mmol/L and - 3.98mmol/L vs - 3.22mmol/L; both p < 0.05) were also significantly higher in FPG levels1 and 2 compared with level3. Linear regression analysis showed a moderate relationship between FPG and HbA1c levels at 24weeks (r = 0.449). Chinese individuals with T2D who achieved lower FPG levels with insulin glargine 100IU/mL were more likely to achieve the recommended target HbA1c of < 7% compared with those with higher FPG levels. ClinicalTrials.gov identifier NCT02545842.