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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

Wenying Yang, Jianhua Ma, Guoyue Yuan, Ling Li, Min Zhang, Yibing Lu, Xinhua Ye, Weihong Song, Ming Liu, Jun Wu, Riqiu Chen, Yunguang Li, Xia Zhang, Nan Cui, Jinkui Yang
Diabetes, Obesity & Metabolism 2019 April 1
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.


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