As more innovative insulin therapies become available, it is necessary to better understand the interrelations between glycaemic metrics of fasting plasma glucose (FPG), postprandial glucose (PPG), HbA1c, and percentage of time in target range 3.9-10.0 mmol/L (%TIR) in patients on insulin therapy.
A pooled analysis was conducted utilizing datasets extracted from an integrated database of insulin lispro clinical trials (Eli Lilly & Company). Studies in patients with type 2 diabetes (T2D), on basal-bolus or basal-plus insulin therapy, and with ≥7-point SMBG profiles were included in the analysis. A multivariate regression model was used to quantify the contribution of FPG and PPG change to the change in HbA1c and %TIR. In addition, a linear regression model was used to describe the relationship between %TIR and HbA1c.
Five studies encompassing 1572 patients met the criteria for inclusion. On average, a 1 mmol/L change in FPG was associated with 0.25% change in HbA1c (range 0.18-0.26%; all p < 0.0001), and a 1 mmol/L change in PPG with 0.16% change in HbA1c (range 0.11-0.19%; all p < 0.01). Furthermore, 1 mmol/L reduction in FPG and PPG was associated with an increase in TIR of 6.5% (range 5.8-9.2%) and 5.3% (range 4.1-8.7%), respectively, all p < 0.0001. A decrease in HbA1c of 1% corresponded with an increase in TIR of 8.3%, on average.
In patients with T2D on basal-bolus or basal-plus insulin therapy, management of both FPG and PPG is important to achieve HbA1c and TIR goals. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
Fasting and Postprandial Plasma Glucose Contribution to HbA1c and Time in Range in People with Type 2 Diabetes on Basal and Bolus Insulin Therapy: Results from a Pooled Analysis of Insulin Lispro Clinical Trials.
