Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov;34(8):e3062.
doi: 10.1002/dmrr.3062. Epub 2018 Oct 2.

Blood glucose profiles in East Asian and Caucasian injection-naive patients with type 2 diabetes inadequately controlled on oral medication: a pooled analysis

Xiao Mei Zhang  1 , Peng Fei Li  2 , Jia Ning Hou  2 , Li Nong Ji  3
Affiliations

Blood glucose profiles in East Asian and Caucasian injection-naive patients with type 2 diabetes inadequately controlled on oral medication: a pooled analysis

Xiao Mei Zhang et al. Diabetes Metab Res Rev. 2018 Nov.

Abstract

Aim: The primary objective of this study was to compare blood glucose (BG) excursions between East Asian and Caucasian patients with type 2 diabetes mellitus (T2DM) who were injection-naive, had inadequate glycemic control with oral antihyperglycemic medications, and who required initiation with injectable therapy.

Methods: This retrospective pooled analysis included individual patient data from completed clinical trials (Insulin lispro injection/dulaglutide development programs, first patient visit ≥1997). All included patients were ≥18 years, were East Asian or Caucasian, and had data for self-monitored BG at baseline. The primary outcome, BG excursion at baseline (least-squares mean, standard error), was compared between patient groups using an analysis of covariance with race as the fixed effect. Independent covariates included baseline body weight, baseline HbA1c, age, and duration of T2DM.

Results: Caucasian (n = 6779) and East Asian (n = 1638) patients from 21 trials were included. BG excursions were significantly higher for East Asian than Caucasian patients at breakfast (4.03 [0.075] vs 2.59 [0.045] mmol/L), lunch (3.37 [0.080] vs 1.43 [0.049] mmol/L), and dinner (3.16 [0.080] vs 1.74 [0.047] mmol/L) (P < 0.001 adjusted analyses). Similar findings were observed for the unadjusted analyses. At each time point, postprandial BG was significantly higher for East Asian than Caucasian patients (with adjusted and unadjusted analyses).

Conclusion: These findings suggest that BG excursion and postprandial BG are higher among East Asian patients with T2DM than Caucasian patients. In addition, these findings may help clinicians select appropriate treatments for East Asian patients with T2DM who require injection therapy.

Keywords: East Asian; blood glucose excursion; diabetes mellitus, type 2.

PubMed Disclaimer

Conflict of interest statement

J.N.H. is an employee of Eli Lilly and Company. P.F.L. was an employee of Eli Lilly and Company at the time of manuscript preparation. L.N.J. has received consulting and lecture fees from Eli Lilly and Company, Bristol‐Myers Squibb, Novartis, Novo Nordisk, Merck, Bayer, Takeda, Sanofi, Roche and Boehringer Ingelheim, and has received research grants from Roche and Sanofi. X.M.Z. has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Pooled analysis of blood glucose excursion for East Asian and Caucasian injection‐naive patients with inadequate glycemic control after oral antihyperglycemic medication. Data are reported as the adjusted least‐squares mean difference between postprandial and preprandial blood glucose at each time point. Error bars denote standard error of the mean. * Blood glucose excursions between East Asians and Caucasians were significantly different at each time point (P < 0.001, adjusted ANCOVA)
Figure 2
Figure 2
Pooled analysis of blood glucose profiles for East Asian and Caucasian injection‐naive patients with inadequate glycemic control after oral antihyperglycemic medication. A, Unadjusted mean preprandial and postprandial blood glucose at each time point. B, Adjusted least‐squares mean preprandial and postprandial blood glucose at each time point. Error bars are not visible as they are within the symbols for each data point. Unadjusted preprandial and postprandial blood glucose and adjusted postprandial blood glucose were significantly different between Caucasians and East Asians at all time points (*P < 0.001, ANCOVA); adjusted prebreakfast blood glucose was significantly higher in Caucasians than in East Asians (P = 0.048)
See this image and copyright information in PMC

References

    1. Bonora E, Corrao G, Bagnardi V, et al. Prevalence and correlates of post‐prandial hyperglycaemia in a large sample of patients with type 2 diabetes mellitus. Diabetologia. 2006;49(5):846‐854. - PubMed
    1. Kovatchev BP. Metrics for glycaemic control—from HbA1c to continuous glucose monitoring. Nat Rev Endocrinol. 2017;13(7):425‐436. - PubMed
    1. International Diabetes Foundation . 2011. Guideline for Management of PostMeal Glucose in Diabetes. https://www.idf.org/our‐activities/advocacy‐awareness/resources‐and‐tool.... Accessed Sep 21, 2017.
    1. Dickinson S, Colagiuri S, Faramus E, Petocz P, Brand‐Miller JC. Postprandial hyperglycemia and insulin sensitivity differ among lean young adults of different ethnicities. J Nutr. 2002;132(9):2574‐2579. - PubMed
    1. Chan JC, Malik V, Jia W, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301(20):2129‐2140. - PubMed

Publication types

MeSH terms