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Fasting Glucose of 6.1 mmol/L as a Possible Optimal Target for Type 2 Diabetic Patients with Insulin Glargine: A Randomized Clinical Trial
Journal of Diabetes Research ( IF 3.6 ) Pub Date : 2021-07-14 , DOI: 10.1155/2021/5524313
Lu Yuan 1 , Fengfei Li 1 , Yue Zhou 1, 2 , Rui Sun 1 , Gu Gao 1 , Qing Zhang 3 , Yajuan Tang 1 , Lu Dai 1 , Jindan Wu 1 , Jianhua Ma 1
Affiliation  

To observe whether different insulin glargine titration algorithms based on fasting blood glucose (FBG) levels lead to different glycaemic variations (GVs) in type 2 diabetes (T2D) patients, a prospective, randomized, single-centre, comparative, three-arm parallel-group, open-label, treat-to-target, 24-week study was performed. A total of 71 uncontrolled T2D patients were recruited and randomized 1 : 3 : 3 into Groups 1, 2, and 3 (insulin titration goals of , ≤6.1, and ≤7.0) for this study. The initiated insulin glargine dose was recommended at 0.2 U/kg/day and was then titrated following the FBG target. Patients were subjected to two 3-day continuous glucose monitoring (CGM) at baseline and the endpoint, wherein the CGM data were analysed, and the study’s primary endpoint was the difference in 24 hrs mean amplitude of glycaemic excursion (MAGE) among the three groups. We observed that patients in the three groups had similar MAGE levels at the endpoint; however, Group 2 achieved a significant decrease in the MAGE level from baseline to the endpoint as compared to Groups 1 and 3 (all ). We also observed that these patients had significant glycated haemoglobin A1c (HbA1c) value improvements as compared to the other two groups (all ). Therefore, choosing an FBG level of 6.1 mmol/L as an insulin titration target provided significant GVs and HbA1c value improvements in T2D patients. Moreover, our data indicated that an FBG of 6.1 mmol/L could possibly be an insulin glargine titration target in T2D patients.

中文翻译:

6.1 mmol/L 的空腹血糖可作为 2 型糖尿病患者使用甘精胰岛素的最佳目标:一项随机临床试验

为了观察基于空腹血糖 (FBG) 水平的不同甘精胰岛素滴定算法是否会导致 2 型糖尿病 (T2D) 患者出现不同的血糖变化 (GV),一项前瞻性、随机、单中心、比较、三臂平行-进行了 24 周组、开放标签、达到目标治疗的研究。共招募了 71 名不受控制的 T2D 患者,并以 1 : 3 : 3 的比例随机分为第 1、2 和 3 组(胰岛素滴定目标为, ≤6.1 和 ≤7.0) 用于本研究。初始甘精胰岛素剂量建议为 0.2 U/kg/天,然后按照 FBG 目标进行滴定。患者在基线和终点接受了两次为期 3 天的连续血糖监测 (CGM),其中分析了 CGM 数据,研究的主要终点是三组之间 24 小时平均血糖波动幅度 (MAGE) 的差异. 我们观察到三组患者在终点的 MAGE 水平相似;然而,与第 1 组和第 3 组相比,第 2 组的 MAGE 水平从基线到终点显着下降(所有)。我们还观察到,与其他两组相比,这些患者的糖化血红蛋白 A1c (HbA1c) 值有显着改善(所有)。因此,选择 6.1 mmol/L 的 FBG 水平作为胰岛素滴定目标可显着改善 T2D 患者的 GV 和 HbA1c 值。此外,我们的数据表明 6.1 mmol/L 的 FBG 可能是 T2D 患者的甘精胰岛素滴定目标。
更新日期:2021-07-14
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