Comparison of Glycemic Excursion Using Flash Continuous Glucose Monitoring in Patients with Type 2 Diabetes Mellitus before and after Treatment with Voglibose

• Main Authors: Anjana, R.M (Author), Gupta, P.K (Author), Honey, E. (Author), Kasthuri, S. (Author), Kayalvizhi, S. (Author), Mohan, V. (Author), Muthukumar, S. (Author), Poongothai, S. (Author), Selvakumar, J. (Author), Tariq, S. (Author), Venkatesan, U. (Author)
• Format: Article
• Language: English
• Published: Mary Ann Liebert Inc. 2021
• Subjects: add on therapy; adult; Adult; aged; antidiabetic agent; Article; Blood Glucose; blood glucose monitoring; Blood Glucose Self-Monitoring; cholesterol blood level; clinical trial; combination drug therapy; controlled study; data analysis software; dermatitis; Diabetes Mellitus, Type 2; diabetic foot; diabetic patient; diarrhea; drug safety; dyspepsia; female; Flash glucose monitoring; FreeStyle Libre ProFlash; gastritis; glucose; Glucose; glucose blood level; Glycated Hemoglobin A; glycemic control; glycemic excursion; Glycemic variability; glycosylated hemoglobin; hemoglobin A1c; high density lipoprotein cholesterol; human; Humans; hyperglycemia; hyperlipidemia; hypertension; hypoglycemia; Hypoglycemic Agents; injury; inositol; Inositol; intervention study; low density lipoprotein cholesterol; major clinical study; male; metformin; multicenter study; nail disease; non insulin dependent diabetes mellitus; open study; Postprandial hyperglycemia; priority journal; Prospective Studies; prospective study; randomized controlled trial; skin infection; sulfonylurea; triacylglycerol; triacylglycerol blood level; Type-2 diabetes mellitus; upper respiratory tract infection; voglibose; Voglibose; α-Glucosidase inhibitor
• Online Access: View Fulltext in Publisher

 Purpose: To determine the effect of Voglibose add-on therapy on daily glycemic excursions (using FreeStyle® Libre Pro™, a Flash glucose monitoring system) in Indian patients with type 2 diabetes mellitus (T2DM) receiving a stable dose of metformin (Met) or metformin+sulfonylurea (Met+SU). Patients and Methods: T2DM patients with glycosylated hemoglobin (HbA1c) ≥7.0% and at least two postprandial excursions ≥140 mg/dL (within 2 h of meal) during the screening phase (visit 1/day-14 ± 2) were enrolled in this prospective, multicenter interventional study. The patients were randomized at visit 2 (day 0 ± 2) to receive Voglibose 0.2 or 0.3 mg tablets (BID/TID) as add-on therapy to Met and Met+SU. All the patients were followed at day 14 ± 2 (visit 3), month 3 ± 14 days (visit 4), 14 weeks (i.e., visit 4 + 14 days) ±2 days (visit 5), and month 6 ± 14 days (visit 6). Continuous glucose monitoring was performed to study glycemic excursions at visits 2, 3, and 5. The study outcomes were: change in average number of glycemic excursions per day, percent time spent in glucose fluctuations, mean Postprandial glucose (PPG), Fasting plasma glucose (FPG), day and night time mean glucose levels from baseline to day 14 and week 14; change in mean amplitude of glycemic excursion (MAGE) from baseline to 14 weeks; and mean HbA1c level at 3 and 6 months. Results: Out of 110 patients enrolled, 101 patients (91.8%) (Met+SU+Voglibose: 73 and Met+Voglibose: 28) completed the study. There was a significant decrease in average number of glycemic excursions per day from baseline to day 14 in the Met+Sul+Voglibose group and to week 14 in the Met+Voglibose group. There was also a significant reduction in percent time spent above target glucose range from baseline to day 14 in both treatment groups and to week 14 in the Met+SU+Voglibose group. A significant reduction in mean PPG area under the curve, day and night time mean glucose levels, and mean FPG levels from baseline to day 14 was reported in both treatment groups. A significant reduction in night time glucose, and average MAGE and HbA1c levels was reported from baseline to week 14 in the Met+Voglibose group and the Met+SU+Voglibose group, respectively. At 6 months, body weight, glucose levels, cholesterol, low-density lipoprotein-cholesterol, and HbA1c were significantly lower, especially in the Met+SU+Voglibose arm. Conclusion: Voglibose was useful in reducing glycemic variability and improving glycemic control in Asian Indian adults with T2DM. (CTRI/2018/04/013074) © Selvam Kasthuri, et al., 2021; Published by Mary Ann Liebert, Inc. 2021.