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Clinical characteristics of type 2 diabetes patients with discordance between HbA 1c and fasting plasma glucose in the real world: A n analysis of the ORBIT study
Author(s) -
Shu Hua,
Lu Juming,
Zhang Puhong,
Zhu Dongshan,
Li Xian,
Ji Jiachao,
Zhao Fang,
Ji Lig
Publication year - 2018
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2977
Subject(s) - medicine , insulin detemir , insulin glargine , diabetes mellitus , endocrinology , gastroenterology , type 2 diabetes , plasma glucose , basal (medicine) , insulin
Background We aimed to determine the clinical characteristics of type 2 diabetes patients on basal insulin therapy with inadequate glucose control due to discordance between glycated haemoglobin (HbA 1c ) and fasting plasma glucose (FPG) in the real world. Methods This was a retrospective analysis of data from the ORBIT study in China. Clinical characteristics of patients with discordance between HbA 1c and FPG at baseline and at the end of 6 months of follow‐up were analysed using multinomial logistic regression in 4 study groups divided by HbA 1c and FPG. Results Overall, of 6721 patients initiated on basal insulin, 853 achieved HbA 1c < 7% but FPG ≥ 7 mmol/L (group 2), while 997 had FPG < 7 mmol/L but HbA 1c ≥ 7% (group 3) at the end of follow‐up. Patients in group 3 had a longer duration of type 2 diabetes compared with those in group 2 (7.22 ± 5.30 vs 6.00 ± 4.80 y, P < .05). Patients on glargine (32.90%) or detemir (36.88%) treatment accounted for a higher proportion of patients with both HbA 1c and FPG controlled than those on neutral protamine Hagedorn therapy (23.45%; P < .05). Per the multinomial logistic analysis, higher frequency of self‐monitoring of blood glucose (SMBG) and use of glargine or detemir therapy were significantly inversely associated with risk of discordance between HbA 1c and FPG, while dose of insulin was a risk factor for discordance at the end of follow‐up (all P < .05). Conclusions Patients treated with insulin analogues (glargine or detemir), instead of neutral protamine Hagedorn, and with more frequent SMBG are more likely to exhibit concordance between HbA 1c and FPG.