Visual Abstract
Background: The randomized, crossover SWITCH PRO trial demonstrated increased time in range (TIR) with insulin degludec vs. insulin glargine U100 in basal insulin-treated type 2 diabetes (T2D). TIR as an emerging glycemic metric, captured by intermittently scanned continuous glucose monitoring (isCGM), may provide a more comprehensive picture of glycemic control than A1C alone. More evidence is required to confidently associate these metrics in insulin-treated T2D. This post hoc analysis of SWITCH PRO aimed to evaluate correlation between TIR and A1C in this less studied population.
Methods: Correlation between absolute values for TIR (70-180 mg/dL) and A1C at baseline (BL) and at the end of maintenance periods 1 (M1) (week 18) and 2 (M2) (week 36) was assessed using the Spearman correlation coefficient (rs).
Results: Scatter plots showed a moderately positive linear correlation between TIR and A1C (Figure) at BL (rs -0.541), which improved with treatment intensification (M1: rs -0.594; M2: rs -0.596). Improved glycemic control following treatment intensification was signified by lower A1C values and greater TIR: 50% TIR corresponded to an estimated A1C 7.9% at BL, 7.8% in M1 and 7.8% in M2; 70% TIR corresponded to an estimated A1C 7.5% at BL, 7.2% in M1 and 7.2% in M2.
Discussion: We observed a correlation between TIR and A1C in T2D treated with basal insulin. Improvement in TIR could be translated to lower A1C levels.
R. Goldenberg: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim (Canada) Ltd., Eli Lilly and Company, HLS Therapeutics Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk Canada Inc., Sanofi, Consultant; Self; AstraZeneca, Boehringer Ingelheim (Canada) Ltd., Eli Lilly and Company, HLS Therapeutics Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk Canada Inc., Sanofi, Research Support; Self; AstraZeneca, Boehringer Ingelheim (Canada) Ltd., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk Canada Inc., Sanofi, Speaker’s Bureau; Self; Agora , Amgen Canada, AstraZeneca, Boehringer Ingelheim (Canada) Ltd., CCRN, CHRC, CMS Canada, CSEM, Eli Lilly and Company, EOCI , HLS Therapeutics Inc., Inceptus, Janssen Pharmaceuticals, Inc., liV Medical Education Agency, Master Clinician Alliance , Medplan, Merck & Co., Inc., Mylan N. V., Novo Nordisk Canada Inc., Sanofi, Servier Laboratories, STA Communications Inc., TKTWG, Valeant . V. R. Aroda: Consultant; Self; Applied Therapeutics, Duke, Novo Nordisk, Pfizer Inc., Sanofi, Employee; Spouse/Partner; Janssen , Merck , Research Support; Self; Applied Therapeutics, Eli Lilly and Company, Fractyl , Medpace, Medpace, Novo Nordisk, Premier , Sanofi, Stock/Shareholder; Spouse/Partner; Janssen, Merck. L. K. Billings: Advisory Panel; Self; Bayer Inc., Lilly Diabetes, Novo Nordisk, Sanofi. A. Meller donatsky: Employee; Self; Novo Nordisk A/S. M. Frederiksen: Employee; Self; Novo Nordisk A/S. D. C. Klonoff: Consultant; Self; EOFlow, Fractyl Laboratories, Inc., LifeCare, Inc., Novo Nordisk, Roche Diagnostic USA, Samsung, Thirdwayv, Employee; Self; DIabetes Technology Society. E. Parvaresh rizi: Employee; Self; Novo Nordisk. R. M. Bergenstal: Advisory Panel; Self; Abbott Diabetes, Eli Lilly and Company, Novo Nordisk, Onduo LLC., Roche , Sanofi, United Healthcare , Consultant; Self; Abbott Diabetes, Ascensia , Dexcom, Inc., Eli Lilly and Company, Hygieia, Johnson & Johnson, Medtronic, Novo Nordisk, Onduo LLC., Roche, Sanofi, United Healthcare, Other Relationship; Self; HealthPartners Institute, Research Support; Self; Abbott Diabetes, Dexcom, Inc., Eli Lilly and Company, Helmsley Charitable Trust, Hygieia, Johnson & Johnson, Medtronic, NIDDK, Novo Nordisk, Onduo LLC., Roche, Sanofi, United Healthcare.
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