Determining the optimal fasting glucose target for patients with type 2 diabetes: results of the multicentre, open-label, randomized-controlled FPG GOAL trial.

The optimal fasting blood glucose (FBG) target to achieve an HbA1c <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%) on 1-3 oral antidiabetic drugs to an FBG target of 3.9<FBG≤5.6 mmol/L (Group 1), 3.9<FBG≤6.1 mmol/L (Group 2), or 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 the proportion of patients achieving an HbA1c <7.0% at 24 weeks. At 24 weeks, 44.4%, 46.1%, and 37.7% of patients achieved an HbA1c <7.0% in Group 1, 2, and 3 (p=0.017; Group 2 vs Group 3). Clinically important hypoglycaemia (glucose ≤3.9 mmol/L) was significantly more frequent in Group 1 vs Group 3 (38.9 vs 23.3%, p<0.001) but not in Group 2 vs Group 3 (27.5% vs 23.3%; p=0.177). Alert hypoglycaemia (glucose ≤3.0 mmol/L) was reported in 4.8%, 2.0% and 3.8% of patients in Groups 1, 2 and 3. In conclusion, the optimal FBG target for most Chinese patients with T2D appears to be 3.9-6.1 mmol/L. This article is protected by copyright. All rights reserved.