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

Abstract

Introduction: FPG GOAL was a 24-week, openlabel, treat-to-target randomized controlled trial which demonstrated that the optimal selfmonitored fasting blood glucose (SM-FBG) target for most Chinese individuals with type 2 diabetes (T2D) using insulin glargine 100 IU/mL was 3.9-6.1 mmol/L. Individuals who achieved lower fasting plasma glucose (FPG) levels might achieve the target HbA1c of \ 7% without increasing the risk of hypoglycemia. Methods: For this post hoc analysis, individuals were redivided into three groups based on their actual laboratory FPG levels at 24 weeks: level 1, B 5.6 mmol/L; level 2, [ 5.6 to B 6.1 mmol/L; and level 3, [ 6.1 to B 7.0 mmol/L. Results: At week 24, 863 individuals with diabetes had available FPG data and 179, 122, and 179 individuals achieved FPG levels 1, 2, and 3, respectively. The proportion of individuals with HbA1c \ 7% or HbA1c \ 7% without hypoglycemia (B 3.9 or B 3.0 mmol/L) was significantly higher in FPG levels 1 (p \ 0.01) and 2 (p \ 0.05) than in level 3. 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 (-3.88 mmol/L and -3.98 mmol/L vs -3.22 mmol/L; both p \ 0.05) were also significantly higher in FPG levels 1 and 2 compared with level 3. Linear regression analysis showed a moderate relationship between FPG and HbA1c levels at 24 weeks (r = 0.449). Conclusions: Chinese individuals with T2D who achieved lower FPG levels with insulin glargine 100 IU/mL were more likely to achieve the recommended target HbA1c of \ 7% compared with those with higher FPG levels. Clini-calTrials.gov identifier NCT02545842.