Importance of targeting post‐prandial hyperglycaemia to achieve HbA1c goals in insulin glargine‐treated subphenotypes of type 2 diabetes
Authors' conclusion
With glargine-based regimens, strict control of PPG is necessary to attain HbA1c <7.0% across all T2D subphenotypes. Therefore, to achieve optimal treatment goals, especially in the SIDD subphenotype, appropriate dose adjustments of both basal and preprandial insulin are required.
Study context
- Population
- Adults with T2D on basal insulin glargine 300 U/mL or 100 U/mL or switched to these basal insulin (BIs) (≥42 U/day) alone or with pre-prandial insulin
- Participants
- 2,435 adults3 EDITION T2D trials
- Comparison
- Responders vs non-responders within T2D subphenotypes
- Outcome
- Achievement of HbA1c goal (<7.0%) by subphenotype
- Follow-up
- 26 weeks
Methodological detailssubphenotype clustering, stratified by HbA1c goal achievement, glargine groups pooled
- Subphenotype clustering
- Stratified by HbA1c goal achievement
- Glargine groups pooled
Pooled result
As reported in the abstract
Responders (HbA1c <7.0%)
Severe Insulin-Deficient Diabetes (SIDD)
19%-33%
Mild Obesity Diabetes (MOD)
33%-56%
Mild Age-Related Diabetes (MARD)
42%-62%
Further pooled results
| Outcome | Responders | Non-responders |
|---|---|---|
| Mean FPG, responders vs non-responders in each subphenotype · 26 weeks | mean 103-128 mg/dL | mean 124-143 mg/dL |
- Mean FPG, responders vs non-responders in each subphenotype: 5.8-7.1 vs 6.9-7.9 mmol/L
Mean FPG, responders vs non-responders in each subphenotype · 26 weeks
- Slightly lower FPG in responders despite equivalent or higher mean glargine doses in non-responders
Self-monitored post-prandial glucose (PPG)
- PPG consistently above target of 140 mg/dL (7.8 mmol/L) in non-responders, even on intensified insulin
Safety
- Hypoglycaemia risk similar or only slightly increased in responders vs non-responders across subphenotypes
Original publication
Importance of targeting post‐prandial hyperglycaemia to achieve HbA1c goals in insulin glargine‐treated subphenotypes of type 2 diabetes. Diabetes Obes Metab. Published 3 November 2025. doi:10.
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