Association of postprandial and fasting plasma glucose with HbA1c across the spectrum of glycaemic impairment in type 2 diabetes

Valensi, P.; Husemoen, Lise Lotte Nystrup; Weatherall, James C.; Monnier, L.

doi:10.1111/ijcp.13041

Cited by 9 publications

(7 citation statements)

References 4 publications

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“…Our findings showed that there is an association between FPG and HbA1c and between PPG and HbA1c: a 1‐mmol/L increase in FPG was associated with a 2.7 mmol/mol (0.25%) increase in HbA1c, while a 1‐mmol/L increase in PPG was associated with 1.8 mmol/mol (0.16%) increase in HbA1c. These results are similar to those previously reported by Valensi et al 12 in a post hoc analysis of the IMPROVE study. Although in their study, in contrast to the present study, only breakfast PPG was assessed and patients were treated with premixed insulin therapy, Valensi et al found that a 1‐mmol/L decrease in FPG was associated with an absolute reduction in HbA1c of 3.0 mmol/mol (0.27%) and a 1‐mmol/L reduction in PPG was associated with an absolute HbA1c reduction of 1.9 mmol/mol (0.17%) 12 .…”

Section: Discussionsupporting

confidence: 93%

“…These results are similar to those previously reported by Valensi et al 12 in a post hoc analysis of the IMPROVE study. Although in their study, in contrast to the present study, only breakfast PPG was assessed and patients were treated with premixed insulin therapy, Valensi et al found that a 1‐mmol/L decrease in FPG was associated with an absolute reduction in HbA1c of 3.0 mmol/mol (0.27%) and a 1‐mmol/L reduction in PPG was associated with an absolute HbA1c reduction of 1.9 mmol/mol (0.17%) 12 . These findings suggest that FPG is more closely associated with HbA1c than PPG in patients with type 2 diabetes on basal and bolus insulin therapy.…”

Section: Discussionsupporting

confidence: 93%

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Fasting and postprandial plasma glucose contribution to glycated haemoglobin and time in range in people with type 2 diabetes on basal and bolus insulin therapy: Results from a pooled analysis of insulin lispro clinical trials

Liao

Chen²,

Chigutsa

et al. 2021

Diabetes Obesity Metabolism

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Aims: To investigate the interrelations between glycaemic metrics of fasting plasma glucose (FPG), postprandial glucose (PPG), glycated haemoglobin (HbA1c), and percentage of time in target range 3.9 to 10.0 mmol/L (%TIR) in patients on insulin therapy.Materials and methods: A pooled analysis was conducted using datasets extracted from an integrated database of insulin lispro clinical trials (Eli Lilly and Company).Studies in patients with type 2 diabetes on basal-bolus or basal-plus insulin therapy, and with ≥7-point self-monitored blood glucose profiles were included in the analysis. A multivariate regression model was used to quantify the contribution of FPG and PPG change to the change in HbA1c and %TIR. In addition, a linear regression model was used to describe the relationship between %TIR and HbA1c.Results: Five studies encompassing 1572 patients met the criteria for inclusion. On average, a 1-mmol/L change in FPG was associated with 2.7 mmol/mol (0.25%) change in HbA1c (range 2.0 to 2.8 mmol/mol [0.18%-0.26%]; all P <0.0001), and a 1-mmol/L change in PPG with 1.8 mmol/mol (0.16%) change in HbA1c (range 1.2 to 2.1 mmol/mol [0.11%-0.19%]; all P <0.01). Furthermore, a 1-mmol/L reduction in FPG and PPG was associated with an increase in TIR of 6.5% (range 5.8%-9.2%) and 5.3% (range 4.1%-8.7%), respectively, all P <0.0001. A decrease in HbA1c of 10.9 mmol/mol (1%) corresponded with an increase in TIR of 8.3%, on average. Conclusions:In patients with type 2 diabetes on basal-bolus or basal-plus insulin therapy, management of both FPG and PPG is important for achievement of HbA1c and TIR goals.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Fasting and postprandial plasma glucose contribution to glycated haemoglobin and time in range in people with type 2 diabetes on basal and bolus insulin therapy: Results from a pooled analysis of insulin lispro clinical trials

Liao

Chen²,

Chigutsa

et al. 2021

Diabetes Obesity Metabolism

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“…Thus, glycemic variability, as a variable that reflects the dynamic process of diabetes control, has received increasing attention. Evidence has shown a more deleterious effect of glycemic variability on coronary arteries compared with that of chronic, sustained hyperglycemia (Kuroda et al, 2015;Škrha et al, 2016;Valensi et al, 2017). The SD of blood glucose is another widely used parameter for the evaluation of intraday glycemic variability and has multiple advantages, including easy access, wide coverage and no application limits (DeVries, 2013;Inzucchi et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

A GLP-1 Analog Liraglutide Reduces Intimal Hyperplasia After Coronary Stent Implantation via Regulation of Glycemic Variability and NLRP3 Inflammasome/IL-10 Signaling in Diabetic Swine

Xia

Liu

et al. 2020

Front. Pharmacol.

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Objective: This study aimed to explore whether treatment with the glucagon-like peptide-1 (GLP-1) analog liraglutide reduces intimal hyperplasia after coronary stent implantation via regulation of glycemic variability, the NLRP3 inflammasome, and IL-10 in diabetic swine. Methods: Fifteen pigs were divided into a diabetes mellitus (DM) group (n = 6), a DM + liraglutide treatment group (L group) (n = 6) and a sham group (n = 3). A total of 24 everolimus-eluting stents were implanted in the left anterior descending and right coronary arteries at 3 weeks. A novel continuous glucose monitoring system (GMS) was used for 2 weeks. The means and standard deviations (SDs) were measured and calculated by the GMS. At 22 weeks, the lumen area (LA), neointimal thickness (NIT), neointimal area (NIA), and percent area stenosis (%AS) were analyzed by optical coherence tomography. Plasma tumor necrosis factor-a, interleukin-6, and interleukin-10 were assayed by ELISA. The intima protein expression levels of NLRP3, interleukin-1b, interleukin-18 and interleukin-10 were examined using Western blot analysis. Histology was used to evaluate the healing response. In an in vitro study, THP-1 cells were divided into control, high glucose (HG), HG + liraglutide, and HG + liraglutide + Exe(9-39) (a GLP-1 receptor inhibitor) groups. Results: The L group had a lower SD, NIT, NIA, and %AS; a larger LA; reduced inflammation and injury scores; lower expression levels of tumor necrosis factor-a, interleukin-6, NLRP3, interleukin-1b, and interleukin-18; and higher expression of interleukin-10 compared with those of the DM group (p < 0.05). In the in vitro study,

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“…Currently, the quality of glycaemic control is not only indicated by HbA1c, but also by continuous glucose monitoring (CGM) metrics such as time in range (TIR), time below range (TBR) and time above range (TAR), which help to elucidate potential areas for glycaemic improvement 8‐10 . Postprandial glucose (PPG) is known to have a significant impact on both HbA1c and TIR in people with type 1 or type 2 diabetes 11‐14 . Inadequately controlled PPG, such as early postprandial hyperglycaemia and late postprandial hypoglycaemia, is associated with unfavourable clinical outcomes for PwD 15‐17 .…”

Section: Evolution From Rai Analogues To Ultra‐rapid–acting Insulinsmentioning

confidence: 99%

“…[8][9][10] Postprandial glucose (PPG) is known to have a significant impact on both HbA1c and TIR in people with type 1 or type 2 diabetes. [11][12][13][14] Inadequately controlled PPG, such as early postprandial hyperglycaemia and late postprandial hypoglycaemia, is associated with unfavourable clinical outcomes for PwD. [15][16][17] While a direct causal relationship between improvement in PPG control and clinical outcomes has not been established in clinical trials, consistently high PPG has been associated with microvascular and macrovascular disease, retinopathy and, in older people with type 2 diabetes, impaired cognitive function.…”

Section: Evolution From Rai Analogues To Ultra-rapid-acting Insulinsmentioning

confidence: 99%

What is the value of faster acting prandial insulin? Focus on ultra rapid lispro

Heise

Oliveira

Juneja

et al. 2022

Diabetes Obesity Metabolism

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Rapid‐acting insulins (RAIs) have been instrumental in the management of diabetes because of their improved postprandial glucose (PPG) control compared with regular human insulin. However, their absorption rate and time action following subcutaneous administration still falls short of the normal physiological response to meal consumption, increasing the risk of early postmeal hyperglycaemia and late postmeal hypoglycaemia. Increased demand for faster acting insulins, which can quickly control PPG excursions without increasing the risk of late hypoglycaemia, led to the development of ultra‐rapid–acting insulins, including ultra‐rapid lispro (URLi). URLi is a novel formulation of insulin lispro with accelerated absorption driven by two excipients: treprostinil, which increases local vasodilation, and citrate, which increases local vascular permeability. Clinical pharmacology studies consistently showed an earlier onset and shorter duration of action with URLi compared with Lispro. In a head‐to‐head study with Faster aspart, Aspart and Lispro, URLi was absorbed faster, provided earlier insulin action, and more closely matched physiological glucose response than the other insulins tested. URLi's unique pharmacokinetic properties increase its potential for improved PPG control beyond that achieved with RAIs. Indeed, in pivotal phase 3 trials, URLi was superior to Lispro for PPG control both at 1 and 2 hours after a meal in type 1 and type 2 diabetes with multiple daily injections, and in type 1 diabetes with continuous subcutaneous insulin infusion. This was achieved without increasing the risk of hypoglycaemia. In this review, we focus on the clinical and pharmacological evidence for URLi in the treatment of diabetes and discuss the potential benefits and considerations with URLi compared with RAIs.

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Association of postprandial and fasting plasma glucose with HbA1c across the spectrum of glycaemic impairment in type 2 diabetes

Cited by 9 publications

References 4 publications

Fasting and postprandial plasma glucose contribution to glycated haemoglobin and time in range in people with type 2 diabetes on basal and bolus insulin therapy: Results from a pooled analysis of insulin lispro clinical trials

Fasting and postprandial plasma glucose contribution to glycated haemoglobin and time in range in people with type 2 diabetes on basal and bolus insulin therapy: Results from a pooled analysis of insulin lispro clinical trials

A GLP-1 Analog Liraglutide Reduces Intimal Hyperplasia After Coronary Stent Implantation via Regulation of Glycemic Variability and NLRP3 Inflammasome/IL-10 Signaling in Diabetic Swine

What is the value of faster acting prandial insulin? Focus on ultra rapid lispro

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