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. 2021 Oct;37(7):e3430.
doi: 10.1002/dmrr.3430. Epub 2021 Mar 2.

The SAGE study: Global observational analysis of glycaemic control, hypoglycaemia and diabetes management in T1DM

Eric Renard  1 , Hiroshi Ikegami  2 , André Gustavo Daher Vianna  3 , Paolo Pozzilli  4   5 , Sandrine Brette  6 , Zsolt Bosnyak  7 , Felipe Lauand  7 , Anne Peters  8 , Valerie Pilorget  7 , Dubravka Jurišić-Eržen  9 , Jothydev Kesavadev  10 , Jochen Seufert  11 , Emma G Wilmot  12
Affiliations

The SAGE study: Global observational analysis of glycaemic control, hypoglycaemia and diabetes management in T1DM

Eric Renard et al. Diabetes Metab Res Rev. 2021 Oct.

Abstract

Aims: To describe glycaemic control and diabetes management in adults with type 1 diabetes (T1DM), in a real-life global setting.

Materials and methods: Study of Adults' GlycEmia (SAGE) was a multinational, multicentre, single visit, noninterventional, cross-sectional study in adult patients with T1DM. Data were collected at a single visit, analysed according to predefined age groups (26-44, 45-64 and ≥65 years) and reported across different regions. The primary endpoint was the proportion of participants achieving HbA1c less than 7.0 % in each age group. Secondary endpoints included incidence of hypoglycaemia, severe hypoglycaemia and severe hyperglycaemia leading to diabetic ketoacidosis (DKA) and therapeutic management of T1DM.

Results: Of 3903 included participants, 3858 (98.8%) were eligible for the study. Overall, 24.3% (95% confidence interval [CI]: 22.9-25.6) of participants achieved the glycaemic target of HbA1c less than 7.0 %, with more participants achieving this target in the 26-44 years group (27.6% [95% CI: 25.5-29.8]). Target achievement was highest in Eastern and Western Europe, and lowest in the Middle East. The incidence of hypoglycaemia and of severe hyperglycaemia leading to DKA tended to decrease with age, and varied across regions. Age and regional differences were observed in therapeutic management, including types of device/insulin usage, frequency of insulin dose adjustment and technology usage.

Conclusions: Glycaemic control remains poor in adults with T1DM globally. Several areas of treatment may be optimised to improve outcomes, including supporting patient self-management of insulin therapy, increasing use of technologies such as CGM, and greater provision of healthcare support.

Keywords: adults; clinical practice; global; glycaemic control; hypoglycaemia; type 1 diabetes.

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Conflict of interest statement

Eric Renard is a consultant/advisor for Abbott, Air Liquide, Cellnovo, Eli Lilly, Insulet, Johnson & Johnson (Animas, LifeScan), Medtronic, Novo Nordisk, Roche Diagnostics and Sanofi‐Aventis and research grant/material support from Abbott, Dexcom, Insulet, Roche Diagnostics and Tandem Diabetes Care. Hiroshi Ikegami receives honoraria for lectures: Astellas, MSD, Terumo, Eli Lilly Japan, Novartis, Novo Nordisk, Research Support: Sumitomo Dainippon Pharma, Otsuka Pharmaceutical, Takeda, Mitsubishi Tanabe Pharma, Novo Nordisk, Abott, Johnson & Johnson, Astellas, Ono Pharmaceutical, Kyowa Kirin, Daiichi Sankyo, Boehringer Ingelhaim Japan and Bayer. André Gustavo Daher Vianna is on advisory board and received speaker fees from Sanofi, Abbott Diabetes Care, Medtronic, Novo Nordisk, Lilly, Servier and Astra‐Zeneca and research grant support from Sanofi, Lilly, Astra‐Zeneca and Novo Nordisk. Paolo Pozzilli is a consultant for Astra Zeneca, Sanofi, Lilly and Abbott. Sandrine Brette is an Aixial employee, mandated by Sanofi. Zsolt Bosnyak, Felipe Lauand and Valerie Pilorget are Sanofi employees and shareholders. Anne Peters received advisory board fees from Abbott diabetes Care, Bigfoot, BI, Eli Lilly, Livongo, MannKind, Novo, Sanofi, Whole Biome and research support: Dexcom, vTvTherapeutics. Stock Options: Mellitus Health, Omada Health, Stability Health, Pendulum Therapeutics. Dubravka Jurišić‐Eržen received consultancy fees from Astra Zeneca, Boehringer Ingelheim, Eli Lily, Novo Nordisk, Sanofi Aventis and Takeda. Jothydev Kesavadev received advisory board and speaker fees from Sanofi, Novo Nordisk, MSD, AstraZeneca, Biocon, Abbott Diabetes Care, Medtronic, Boehringer Ingelheim and Johnson & Johnson. Jochen Seufert is an advisory board member of Abbott, AstraZeneca, Boehringer Ingelheim, GI Dynamics, Janssen, LifeScan Mundipharma Novartis, Novo Nordisk, Sanofi Speaker Abbott, AstraZeneca, Bayer, Berlin Chemie Boehringer Ingelheim, Bristol Myers Squibb, Janssen, Eli Lilly, Merck Sharp Dohme (MSD) MedScape Novartis, Novo Nordisk, Omniamed Sanofi; research support from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, GI Dynamics, Intarcia Ipsen, Janssen, Novartis, Novo Nordisk, Sanofi, Ypsomed. Emma G. Wilmot received personal fees from Abbott Diabetes Care, Dexcom, Eli Lilly, Medtronic, Novo Nordisk and Sanofi Aventis.

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