Dataset Information

Glycemic control status, diabetes management patterns, and clinical characteristics of adults with type 1 diabetes in Japan: Study of Adults' Glycemia in T1DM subanalysis.

ABSTRACT:

Aims/introduction

Type 1 diabetes is rare in the general Japanese population, but becoming more common in adults with increased longevity owing to advancements in treatment. We aimed to examine the current state of glycemic control and diabetes management using real-world data on Japanese adults with type 1 diabetes in different age groups.

Materials and methods

This was a subanalysis of Japanese participants from a multinational, cross-sectional, observational study of adults with type 1 diabetes aged ≥ 26 years conducted in 2018 (Study of Adults' Glycemia in T1DM). Glycemic control achievement rate and goal setting, incidence of hypoglycemia, and diabetes management of individuals aged 26‒44 years, 45‒64 years, and ≥ 65 years were summarized.

Results

The data on 528 participants were analyzed. The mean glycated hemoglobin (HbA1c) value was 7.8% (61.3 mmol/mol). Of the participants, 25.8% achieved an HbA1c level of < 7.0% (26-44 years, 33.7%; 45‒64 years, 18.9%; and ≥ 65 years, 24.3%). In total, 71.4% participants reported ≥ 1 symptomatic hypoglycemic episode within the last 3 months, and 5.5% participants reported ≥ 1 severe hypoglycemic episode within the last 6 months. A less stringent individualized goal was set for participants aged ≥ 65 years; they had the lowest incidence of ≥ 1 symptomatic hypoglycemic episode. Insulin pumps and continuous glucose monitoring were used in 23.5% and 33.9% participants, respectively.

Conclusion

Glycemic control was suboptimal; the low incidence of severe hypoglycemia suggests careful glycemic control, balancing benefits and risks, particularly in Japanese adults aged ≥ 65 years with type 1 diabetes.

Supplementary information

The online version contains supplementary material available at 10.1007/s13340-021-00504-7.

SUBMITTER: Abiru N

PROVIDER: S-EPMC8413413 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Publications

Glycemic control status, diabetes management patterns, and clinical characteristics of adults with type 1 diabetes in Japan: Study of Adults' Glycemia in T1DM subanalysis.

Abiru Norio N Shimada Akira A Nishimura Rimei R Matsuhisa Munehide M Ozaki Asuka A Ikegami Hiroshi H

Diabetology international 20210425 4

<h4>Aims/introduction</h4>Type 1 diabetes is rare in the general Japanese population, but becoming more common in adults with increased longevity owing to advancements in treatment. We aimed to examine the current state of glycemic control and diabetes management using real-world data on Japanese adults with type 1 diabetes in different age groups.<h4>Materials and methods</h4>This was a subanalysis of Japanese participants from a multinational, cross-sectional, observational study of adults wit ...[more]

PMID: 34567927

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Project description:BackgroundThe comparative effectiveness of glucose-lowering medications for use with metformin to maintain target glycated hemoglobin levels in persons with type 2 diabetes is uncertain.MethodsIn this trial involving participants with type 2 diabetes of less than 10 years' duration who were receiving metformin and had glycated hemoglobin levels of 6.8 to 8.5%, we compared the effectiveness of four commonly used glucose-lowering medications. We randomly assigned participants to receive insulin glargine U-100 (hereafter, glargine), the sulfonylurea glimepiride, the glucagon-like peptide-1 receptor agonist liraglutide, or sitagliptin, a dipeptidyl peptidase 4 inhibitor. The primary metabolic outcome was a glycated hemoglobin level, measured quarterly, of 7.0% or higher that was subsequently confirmed, and the secondary metabolic outcome was a confirmed glycated hemoglobin level greater than 7.5%.ResultsA total of 5047 participants (19.8% Black and 18.6% Hispanic or Latinx) who had received metformin for type 2 diabetes were followed for a mean of 5.0 years. The cumulative incidence of a glycated hemoglobin level of 7.0% or higher (the primary metabolic outcome) differed significantly among the four groups (P<0.001 for a global test of differences across groups); the rates with glargine (26.5 per 100 participant-years) and liraglutide (26.1) were similar and lower than those with glimepiride (30.4) and sitagliptin (38.1). The differences among the groups with respect to a glycated hemoglobin level greater than 7.5% (the secondary outcome) paralleled those of the primary outcome. There were no material differences with respect to the primary outcome across prespecified subgroups defined according to sex, age, or race or ethnic group; however, among participants with higher baseline glycated hemoglobin levels there appeared to be an even greater benefit with glargine, liraglutide, and glimepiride than with sitagliptin. Severe hypoglycemia was rare but significantly more frequent with glimepiride (in 2.2% of the participants) than with glargine (1.3%), liraglutide (1.0%), or sitagliptin (0.7%). Participants who received liraglutide reported more frequent gastrointestinal side effects and lost more weight than those in the other treatment groups.ConclusionsAll four medications, when added to metformin, decreased glycated hemoglobin levels. However, glargine and liraglutide were significantly, albeit modestly, more effective in achieving and maintaining target glycated hemoglobin levels. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; GRADE ClinicalTrials.gov number, NCT01794143.).

Project description:Abstract Objectives Low-glycemic index (GI) and load (GL) dietary patterns are recommended for diabetes management by clinical practice guidelines globally. To inform the update of the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy, we conducted a systematic review and meta-analysis on the effect of low-GI/GL dietary patterns on glycemic control and other established cardiometabolic risk factors in type 1 and 2 diabetes. Methods MEDLINE, EMBASE, and the Cochrane Library were searched through November 2020. We included randomized controlled trials ≥3-weeks investigating the effect of low-GI/GL diets in diabetes. The primary outcome was HbA1c. Two independent reviewers extracted data and assessed risk of bias. GRADE (grading of recommendations assessment, development, and evaluation) assessed the certainty of the evidence. (ClinicalTrials.gov identifier, NCT04045938) Results We identified 30 trial comparisons in 1,672 participants with type 1 and 2 diabetes who were predominantly middle-aged, overweight or obese with moderately controlled type 2 diabetes treated by antihyperglycemic agents and/or insulin. Low-GI/GL dietary patterns significantly reduced HbA1c compared with higher-GI/GL control diets (mean difference −0.32% [95% confidence interval −0.48, −0.16%], P < 0.001; substantial heterogeneity, I2 = 74%, P < 0.001). There were also significant reductions in several secondary outcomes: fasting glucose, LDL-C, non-HDL-C, body weight, BMI, and CRP (P < 0.05), but not insulin or blood pressure. The certainty of evidence was moderate for the reduction in HbA1c and most secondary outcomes. Conclusions Our synthesis indicates that low-GI/GL dietary patterns improve established targets of glycemic control, blood lipids, adiposity and inflammation beyond concurrent therapy with antihyperglycemic agents and/or insulin in moderately controlled type 1 and type 2 diabetes. The available evidence provides a good indication of the likely benefit in this population with moderate likelihood that more research will alter our conclusions. Funding Sources Diabetes and Nutrition Study Group of the EASD, CIHR.

Dataset Information

Glycemic control status, diabetes management patterns, and clinical characteristics of adults with type 1 diabetes in Japan: Study of Adults' Glycemia in T1DM subanalysis.

Aims/introduction

Materials and methods

Results

Conclusion

Supplementary information

Publications

Glycemic control status, diabetes management patterns, and clinical characteristics of adults with type 1 diabetes in Japan: Study of Adults' Glycemia in T1DM subanalysis.

Similar Datasets

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