Low fasting glucose-to-estimated average glucose ratio was associated with superior response to insulin degludec/aspart compared with basal insulin in patients with type 2 diabetes
Journal of Diabetes Investigation Sep 01, 2021
Jang HN, Yang YS, Oh TJ, et al. - In patients with a fasting plasma glucose (FPG) lower than predicted by glycated hemoglobin (HbA1c), insulin degludec/aspart (IDegAsp) was more effective than basal insulin, which could be related to insulin deficiency and postprandial hyperglycemia in patients on basal insulin therapy.
It was a retrospective observational study.
Patients were recruited who initiated once-daily IDegAsp from a basal insulin cohort from three referral hospitals.
There were 87 patients in the IDegAsp group and 87 participants in the control group.
The two groups had similar baseline HbA1c levels (8.7 ± 0.9 vs 8.6 ± 0.9%, mean and standard deviation).
HbA1c in the IDegAsp group was lower than in the control group (8.1 ± 1.0 vs 8.4 ± 1.1%) after 6 months of matched insulin doses.
FPG and fasting C-peptide were both lower in the IDegAsp than in the control group (FPG 124.2 ± 38.4 vs 148.0 ± 50.6 mg/dL).
Subgroup analysis was performed using a ratio of FPG-to-estimated average glucose, which is determined from HbA1c because the reduced FPG despite comparable HbA1c could be connected to the efficacy of IDegAsp.
The superiority of IDegAsp in reducing HbA1c was significant only in patients with a lower FPG-to-estimated average glucose ratio, but not in those with a greater FPG-to-estimated average glucose ratio, as compared with each control group.
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