Contribution of basal and postprandial hyperglycaemia in type 2 diabetes patients treated by an intensified insulin regimen: Impact of pump therapy in the OPT2mise trial

Reznik, Yves; Habteab, Aklilu; Castañeda, Javier; Shin, John; Joubert, Michaël

doi:10.1111/dom.13398

Cited by 6 publications

(7 citation statements)

References 31 publications

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“…Indeed, in a previous report, we explored the relative contribution of basal and postprandial hyperglycaemia to HbA1c with a post hoc analysis of CGM data from the largest randomized controlled trial comparing MDI versus CSII in T2D patients that has been reported 6,18 . Among patients who switched from MDI to CSII, we reported a reduction of the relative contribution of basal hyperglycaemia but an increase in the relative contribution of postprandial hyperglycaemia, especially in patients with higher baseline HbA1c 18 . These results support a therapeutic intensification strategy targeting postprandial hyperglycaemia for T2D patients with uncontrolled HbA1c despite CSII treatment.…”

Section: Discussionmentioning

confidence: 98%

Efficacy and safety of exenatide as add‐on therapy for patients with type 2 diabetes with an intensive insulin regimen: A randomized double‐blind trial

Joubert

Opigez

Pavlikova

et al. 2020

Diabetes Obesity Metabolism

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Aim To assess the safety and efficacy of the short‐acting glucagon‐like peptide‐1 receptor agonist exenatide on a population of patients with type 2 diabetes (T2D) mostly treated with continuous subcutaneous insulin injection (CSII). Materials and Methods A phase 2/3, multicentre, randomized, parallel‐group, double‐blind, placebo‐controlled, 6‐month trial was conducted. Patients were randomized to receive subcutaneous (SC) injections of exenatide (10 μg BID) or matched placebo. Results A total of 46 patients with T2D and elevated HbA1c were randomized (42% of the planned sample size): exenatide (n = 28) and placebo (n = 18). CSII treatment was used by 75% and 89% of patients of the exenatide and placebo groups, respectively. At 6 months, the change in HbA1c was −0.62% ± 0.94% and 0.08% ± 0.81% in the exenatide and placebo groups, respectively (difference, −0.70%; 95% CI [−1.24%; −0.15%], P = .014); body weight and body mass index decreased in the exenatide group (−2.55 ± 3.25 kg and −1.00 ± 1.31 kg/m2) and increased in the placebo group (1.29 ± 2.82 kg and 0.46 ± 1.16 kg/m2) (observed difference, −3.85 and −1.45, respectively, both P < .001); the postdinner capillary blood glucose value was lower in the exenatide group compared with the placebo group (162.4 ± 80.5 vs. 259.1 ± 94.4 mg/dL, respectively; observed difference, −96.7, P < .01). Hypoglycaemic risk, quality of life and overall safety were not different between the groups, apart from the expected occurrence of digestive effects in the exenatide group. Conclusions Although we failed to reach our planned sample size, the addition of exenatide treatment 10 μg BID SC in T2D patients with uncontrolled HbA1c despite an intensified insulin regimen, resulted in a significant reduction of HbA1c and body weight with a good overall safety profile and acceptance.

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Section: Discussionmentioning

confidence: 98%

Efficacy and safety of exenatide as add‐on therapy for patients with type 2 diabetes with an intensive insulin regimen: A randomized double‐blind trial

Joubert

Opigez

Pavlikova

et al. 2020

Diabetes Obesity Metabolism

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“…PPG’s contribution rate decreased with increasing HbA1c (from 65.5% to 39.2%). Reznik et al 21 (2018) 259 (a) T2DM treated by insulin (b) Non-oral drug treated (c) Multicenter study (Canada, Europe, United States, Africa) ≥5.6 (a) OPT2mise trial (b) maintained efforts at lifestyle and dietary management, but carbohydrate counting was not required 8.9 ± 0.8 PPG accounts for only 20% to 30% of overall hyperglycaemia, regardless of the baseline HbA1c level who fail to respond to an intensified MDI regimen. Umpierrez et al 23 (2019) 673 (a) Type 2 diabetes on dulaglutide (b) ND (c) Caucasians ≥5.6 (a) Seven-point SMBG ND 8.1 ± 0.94 The relative contributions of PPG accounted for nearly 52% when HbA1c < 7.0% but only about 23% when HbA1c ≥ 9%.…”

Section: Introductionmentioning

confidence: 99%

“…Bergenstal 28 stated that CGM has transformed glucose control and can be used to identify glucose excursions in patients with diabetes. The recent development of some new therapies specifically aimed at reducing BG or PPG has further increased the interest for studying the complex relationship between the contributions of BG and PPG, yet have yielded conflicting results 20 , 21 , 23 , 25 . Recently, the results of a randomised crossover trial conducted by CGMS pointed that the conflicting results may be related to differences in the study population, methodologies, etc 29 .…”

Section: Introductionmentioning

confidence: 99%

“…However, the A1 C -derived average glucose study 8 showed that BG was not a clear indicator of general glycaemia. Table 1 summarizes 17 relevant studies 6,7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] published up to Jan 1, 2021. It shows the complex results on the relative contribution of PPG to HbA1c in diverse subjects, treatment regimens, and baseline criterias.…”

Section: Introductionmentioning

confidence: 99%

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A new approach for investigating the relative contribution of basal glucose and postprandial glucose to HbA1C

Yang

et al. 2021

Nutr. Diabetes

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To develop an accurate method for evaluating the relative contributions of basal glucose (BG) and postprandial glucose (PPG) to glycated haemoglobin (HbA1c) in subjects with hyperglycaemia using a Continuous Glucose Monitoring System (CGMS®). The subjects were divided into the normal glucose tolerance (NGT), impaired glucose tolerance (IGT), newly-diagnosed type 2 diabetes (NDDM), and drug-treated type 2 diabetes (T2DM) groups. We evaluated the relative contributions of BG and PPG to HbA1c in patients with hyperglycaemia according to three different baseline values. Subjects (n = 490) were grouped as follows: 92 NGT, 36 IGT, 131 NDDM, and 231 T2DM. The relative contributions of PPG to HbA1c were calculated using baseline values of 6.1 mmol/L, 5.6 mmol/L, and the 24-h glucose curve of the NGT group. The relative contribution of PPG to HbA1c decreased progressively from the IGT group to the T2DM group. Compared with the 24-h glucose curve as the baseline, the relative contribution of PPG was overestimated in 9.04% and 1.76% of the subjects when 6.1 mmol/L and 5.6 mmol/L were used as baselines, respectively (P < 0.01), in T2DM patients. The 24-h glucose curve of NGT is more suitable for studying the relative contributions of BG and PPG to HbA1c and it is more precise, as it considers physiological fluctuations in NGT after meals. However, 5.6 mmol/L can be used when the 24-h glucose curve for NGT is unavailable; using 6.1 mmol/L as a baseline value may overestimate the contribution to the HbA1c. There is no unified standard for assessing the contributions of basal glucose (BG) and postprandial glucose (PPG) to HbA1c. The 24-h glucose curve of NGT is more suitable for studying the relative contributions of BG and PPG to HbA1c, as it considers physiological fluctuations in NGT after meals. However, 5.6 mmol/L can be used when the 24-h glucose curve for NGT is unavailable; using 6.1 mmol/L as a baseline value may overestimate the contribution to the HbA1c.

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“…One of these diseases that causing kidney disease and risk on microvascular is diabetes mellitus [2]. and this risk increased with glucose abnormalities [3]. The volume and composition of body fluids are tightly regulated by kidney, and the kidneys are largely responsible for maintaining regulatory or homeostasis of electrolytes and fluids in the body [4].…”

Section: Introductionmentioning

confidence: 99%

Effect of Metformin and Glimepiride Treatment on Some Biochemical Parameters in Diabetic Male Patients with Chronic Renal Failure

Abbed¹

2019

IHJPAS

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The present study was included a measurements of fasting serum glucose, total protein, potassium, and calcium levels in the sera of 25 diabetic male patients suffer from chronic renal failure; their ages range were (32-75) and compared them with 25 healthy males as control group. The aim of this study was to study the effects of antidiabetic drugs on some biochemical parameters such as fasting serum glucose, serum total protein, serum potassium and calcium. The current results demonstrated a hyperkalemia in patients and this increasing of potassium is significantly (p = 0.03), but calcium level showed no significant variations ( p>0.05 ), and serum total protein was significantly decreased in patients as compared to the controls( p = 0.0002 ).

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Contribution of basal and postprandial hyperglycaemia in type 2 diabetes patients treated by an intensified insulin regimen: Impact of pump therapy in the OPT2mise trial

Abstract: Basal hyperglycaemia is the major determinant of overall exposure to hyperglycaemia in type 2 diabetes with MDI failure.

Cited by 6 publications

References 31 publications

Efficacy and safety of exenatide as add‐on therapy for patients with type 2 diabetes with an intensive insulin regimen: A randomized double‐blind trial

Efficacy and safety of exenatide as add‐on therapy for patients with type 2 diabetes with an intensive insulin regimen: A randomized double‐blind trial

A new approach for investigating the relative contribution of basal glucose and postprandial glucose to HbA1C

Effect of Metformin and Glimepiride Treatment on Some Biochemical Parameters in Diabetic Male Patients with Chronic Renal Failure

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