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Determining the optimal fasting glucose target for patients with type 2 diabetes: Results of the multicentre, open‐label, randomized‐controlled FPG GOAL trial
Author(s) -
Yang Wenying,
Ma Jianhua,
Yuan Guoyue,
Li Ling,
Zhang Min,
Lu Yibing,
Ye Xinhua,
Song Weihong,
Liu Ming,
Wu Jun,
Chen Riqiu,
Li Yunguang,
Zhang Xia,
Cui Nan,
Yang Jinkui
Publication year - 2019
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.13733
Subject(s) - medicine , type 2 diabetes , clinical endpoint , insulin glargine , randomized controlled trial , gastroenterology , diabetes mellitus , insulin , endocrinology
Abstract The optimal fasting blood glucose (FBG) target of achieving HbA1c less than 7.0% in type 2 diabetes (T2D) patients remains controversial. This open‐label trial randomized (1:3:3) 947 adults with uncontrolled T2D (HbA1c >7% to ≤10.5%) who were using one to three oral antidiabetic drugs to achieve an FBG target of 3.9 < FBG ≤5.6 mmol/L (Group 1), 3.9 < FBG ≤6.1 mmol/L (Group 2) or of 3.9 < FBG ≤7.0 mmol/L (Group 3). Targets were achieved using a pre‐defined insulin glargine 100 U/mL titration scheme. The primary endpoint was proportion of patients achieving HbA1c <7.0% at 24 weeks. At 24 weeks, 44.4%, 46.1% and 37.7% of patients achieved HbA1c <7.0% in Groups 1, 2 and 3, respectively ( P = 0.017; Group 2 vs Group 3). Alert hypoglycaemia (glucose ≤3.9 mmol/L) was significantly more frequent in Group 1 than in Group 3 (38.9 vs 23.3%; P < 0.001) but was not in Group 2 vs Group 3 (27.5% vs 23.3%; P = 0.177). Clinically important hypoglycaemia (glucose ≤3.0 mmol/L) was reported in 4.8%, 2.0% and 3.8% of patients in Groups 1, 2 and 3, respectively. In conclusion, the optimal FBG target for most Chinese patients with T2D appears to be 3.9‐6.1 mmol/L.