Postprandial Glucose Excursions in Asian Versus Non-Asian Patients with Type 2 Diabetes: A Post Hoc Analysis of Baseline Data from Phase 3 Randomised Controlled Trials of IDegAsp

Wenying Yang, Shahid Akhtar, Edward Franek, Martin Haluzík, Takahisa Hirose, Balamurali Kalyanam, Soumitra Kar, Ted Wu, Dilek Gogas Yavuz, Ambika Gopalakrishnan Unnikrishnan, Wenying Yang, Shahid Akhtar, Edward Franek, Martin Haluzík, Takahisa Hirose, Balamurali Kalyanam, Soumitra Kar, Ted Wu, Dilek Gogas Yavuz, Ambika Gopalakrishnan Unnikrishnan

Abstract

Introduction: Increased postprandial glucose (PPG) is associated with high glycated haemoglobin levels and is an independent risk factor for cardiovascular diseases. The aim of this study was to compare PPG increments in Asian versus non-Asian adults with type 2 diabetes (T2D), who were insulin-naïve or insulin-experienced, from the phase 3 insulin degludec/insulin aspart (IDegAsp) clinical trials.

Methods: This was a post hoc analysis of data from 13 phase 3, randomised, parallel-group, open-label IDegAsp trials in patients with T2D. The pooled baseline clinical data were analysed for insulin-naïve and insulin-experienced groups; and each group was split into subgroups of Asian and non-Asian patients, respectively, and analysed accordingly. Baseline self-monitored blood glucose (SMBG) values at breakfast, lunch and the evening meal (before and 90 min after each meal) were used to assess PPG increments. The estimated differences in baseline SMBG increment between the Asian and non-Asian subgroups were analysed.

Results: Clinical data from 4750 participants (insulin-naïve, n = 1495; insulin-experienced, n = 3255) were evaluated. In the insulin-naïve group, the postprandial SMBG increment was significantly greater in the Asian versus the non-Asian subgroup at breakfast (estimated difference 28.67 mg/dL, 95% confidence interval [CI] 18.35, 38.99; p < 0.0001), lunch (17.34 mg/dL, 95% CI 6.47, 28.21; p = 0.0018) and the evening meal (16.19 mg/dL, 95% CI 5.04, 27.34; p = 0.0045). In the insulin-experienced group, the postprandial SMBG increment was significantly greater in the Asian versus non-Asian subgroup at breakfast (estimated difference 13.81 mg/dL, 95% CI 9.19, 18.44; p < 0.0001) and lunch (29.18 mg/dL, 95% CI 24.22, 34.14; p < 0.0001), but not significantly different at the evening meal.

Conclusion: In this post hoc analysis, baseline PPG increments were significantly greater in Asian participants with T2D than in their non-Asian counterparts at all mealtimes, with the exception of the evening meal in insulin-experienced participants. Asian adults with T2D may benefit from the use of regimens that control PPG excursions.

Clinical trial numbers: NCT02762578, NCT01814137, NCT01513590, NCT01009580, NCT01713530, NCT02648217, NCT01045447, NCT01365507, NCT01045707, NCT01272193, NCT01059812, NCT01680341, NCT02906917.

Trial registration: ClinicalTrials.gov NCT02762578 NCT01814137 NCT01513590 NCT01009580 NCT01713530 NCT02648217 NCT01045447 NCT01365507 NCT01045707 NCT01272193 NCT01059812 NCT01680341 NCT02906917 NCT01513590 NCT01045707 NCT01045447 NCT01059812 NCT01272193 NCT01009580 NCT01365507 NCT02648217 NCT01814137 NCT02906917 NCT29069172 NCT01713530 NCT02762578 NCT01680341.

Keywords: Asian; Diabetes management; IDegAsp; Postprandial glucose excursion; Type 2 diabetes.

© 2022. The Author(s).

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