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Diabetes Obes Metab. 2019 Aug;21(8):1973-1977. doi: 10.1111/dom.13733. Epub 2019 Jun 10.

Determining the optimal fasting glucose target for patients with type 2 diabetes: Results of the multicentre, open-label, randomized-controlled FPG GOAL trial.

Author information

1
Endocrine Department, China-Japan Friendship Hospital, Beijing, China.
2
Endocrine Department, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
3
Endocrine Department, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
4
Endocrine Department, Shengjing Hospital of China Medical University, Shenyang, China.
5
Endocrine Department, Qingpu Branch of Zhongshan Hospital, Affiliated with Fudan University, Shanghai, China.
6
Endocrine Department, The Second Affiliated Hospital, Nanjing Medical University, Nanjing, China.
7
Endocrine Department, Changzhou Second People's Hospital, Affiliated with Nanjing Medical University, Changzhou, China.
8
Endocrine Department, Chenzhou No. 1 People's Hospital, Chenzhou, China.
9
Endocrine Department, Tianjin Medical University General Hospital, Tianjin, China.
10
Endocrine Department, The Third Hospital of Wuhan, Wuhan, China.
11
Endocrine Department, Lishui People's Hospital, Lishui, China.
12
Medical Department, Sanofi Investment Co., Ltd., Shanghai, China.
13
Endocrine Department, Beijing Tongren Hospital, Beijing, China.

Abstract

The optimal fasting blood glucose (FBG) target of achieving HbA1c less than 7.0% in type 2 diabetes (T2D) patients remains controversial. This open-label trial randomized (1:3:3) 947 adults with uncontrolled T2D (HbA1c >7% to ≤10.5%) who were using one to three oral antidiabetic drugs to achieve an FBG target of 3.9 < FBG ≤5.6 mmol/L (Group 1), 3.9 < FBG ≤6.1 mmol/L (Group 2) or of 3.9 < FBG ≤7.0 mmol/L (Group 3). Targets were achieved using a pre-defined insulin glargine 100 U/mL titration scheme. The primary endpoint was proportion of patients achieving HbA1c <7.0% at 24 weeks. At 24 weeks, 44.4%, 46.1% and 37.7% of patients achieved HbA1c <7.0% in Groups 1, 2 and 3, respectively (P = 0.017; Group 2 vs Group 3). Alert hypoglycaemia (glucose ≤3.9 mmol/L) was significantly more frequent in Group 1 than in Group 3 (38.9 vs 23.3%; P < 0.001) but was not in Group 2 vs Group 3 (27.5% vs 23.3%; P = 0.177). Clinically important hypoglycaemia (glucose ≤3.0 mmol/L) was reported in 4.8%, 2.0% and 3.8% of patients in Groups 1, 2 and 3, respectively. In conclusion, the optimal FBG target for most Chinese patients with T2D appears to be 3.9-6.1 mmol/L.

KEYWORDS:

fasting blood glucose; glycated haemoglobin; insulin glargine; type 2 diabetes

PMID:
30938035
DOI:
10.1111/dom.13733

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