Published in:
01-03-2015 | Original Article
Plasma glucose monitoring and the subsequent HbA1c control in patients with type 2 diabetes on a basal supported oral therapy regimen in real life: subanalysis of the ALOHA study: a 24-week, prospective, open-label, multicenter, observational study
Published in: Diabetology International | Issue 1/2015
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Background
Adjusting the basal insulin dose based on fasting plasma glucose (FPG) levels
can facilitate better glycemic control. We examined whether FPG monitoring was associated with the optimal HbA1c target of <7.0 %, maintaining a low hypoglycemic rate, through comparison between FPG monitoring and six other monitoring methods.
Methods
The actual clinical practice data on 3508 insulin-naïve patients, whose plasma glucose measurement data were available, were obtained from the Add-on Lantus® to Oral Hypoglycemic Agents study, a 24-week, prospective, open-label, multicenter, observational study conducted in 2007–2009 in 987 hospitals and clinics throughout Japan. The patients were divided into seven groups by their plasma glucose monitoring methods [e.g., FPG alone, FPG and postprandial plasma glucose (PPG), i.e., FPG and PPG measured at different visits]. Rates of HbA1c level <7.0 % achievement at 24 weeks, hypoglycemia, and compliance with diet and exercise instruction were compared between the FPG group and other monitoring groups.
Results
The FPG alone group showed the highest rate (21.3 %) of achieving an HbA1c level <7.0 % at 24 weeks followed by the FPG/PPG group (19.2 %) and PPG alone group (18.4 %). The FPG alone group recorded the lowest hypoglycemic rate and the highest the compliance rate. The glargine dose seemed to have been titrated most appropriately in the FPG alone group.
Conclusions
Our results suggest an association between FPG monitoring and titration of the glargine dose based on FPG levels and achieving target glycemic levels, with fewer hypoglycemic events in Japanese patients with type 2 diabetes treated with glargine basal supported oral therapy (BOT).