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Tayek CJ, Cherukuri L, Hamal S, et al. Importance of fasting blood glucose goals in the management of type 2 diabetes mellitus: a review of the literature and a critical appraisal. J Diabetes Metab Disord Control. 2018;5(4):113-117doi: 10.15406/jdmdc.2018.05.00148.
Tayek, C. J., Cherukuri, L., Hamal, S., & Tayek, J. A. (2018). Importance of fasting blood glucose goals in the management of type 2 diabetes mellitus: a review of the literature and a critical appraisal. Journal of diabetes, metabolic disorders & control, 5(4), 113-117. https://doi.org/10.15406/jdmdc.2018.05.00148
Tayek, Chandler J, et al. "Importance of fasting blood glucose goals in the management of type 2 diabetes mellitus: a review of the literature and a critical appraisal." Journal of diabetes, metabolic disorders & control vol. 5,4 (2018): 113-117. doi: https://doi.org/10.15406/jdmdc.2018.05.00148
Tayek CJ, Cherukuri L, Hamal S, Tayek JA. Importance of fasting blood glucose goals in the management of type 2 diabetes mellitus: a review of the literature and a critical appraisal. J Diabetes Metab Disord Control. 2018;5(4):113-117. doi: 10.15406/jdmdc.2018.05.00148. Epub 2018 Jul 20. PMID: 31404422; PMCID: PMC6688759.
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J Diabetes Metab Disord Control. 2018;5(4):113-117. doi: 10.15406/jdmdc.2018.05.00148. Epub 2018 Jul 20.

Importance of fasting blood glucose goals in the management of type 2 diabetes mellitus: a review of the literature and a critical appraisal.

Journal of diabetes, metabolic disorders & control

Chandler J Tayek, Lavanya Cherukuri, Sajad Hamal, John A Tayek

Affiliations

  1. Department of Internal Medicine, Los Angeles Bio-Medical Research Institute, USA.

PMID: 31404422 PMCID: PMC6688759 DOI: 10.15406/jdmdc.2018.05.00148

Abstract

Prandial insulin has been essential for the improved management of the type 1 diabetic patient. Interestingly, many studies have evaluated the addition of prandial insulin to the type 2 diabetic patients with improved control. The greatest drop in A1c with the use of various type of prandial insulins have resulted in the decrease of 1.3% in the A1c measurement. Interestingly, none of the published trials with goal of fasting blood glucose (FBG) have ever obtained the goal A1c. Since a drop in FBG of 28.7mg/dl is equal to a 1% drop in A1c, a simple approach to obtain a target A1c would be to focus on the FBG (per ADA: Average Blood Glucose = A1c (%) x 28.7 - 46.7mg/d). However, average blood glucose requires multiple measurements and may be less accurate then using just a FBG. Since prandial insulin clinical trials have only demonstrated a drop in A1c by 0.3-1.3% the use of only a FBG to help patients get to goal may be easier to teach and to obtain. It might save time and money. Our hypothesis is that if patient obtain a FBG <100 mg/dl for 2-3 months then 70% will be at an A1c goal <7.0%. After a few months of good fasting glucose control the provider can use this equation (FBG+80)/30 to estimate A1c. For example, a FBG of 130mg/dl would be (130 + 80)/30 = 7.0%; or a FBG of 190 would be (190+80)/30 =eA1c 9% (estimate of A1c). While type 1 diabetes has a very complex daily glucose pattern, the approach to type 2 diabetics on insulin could become simplified.

Conflict of interest statement

Conflicts of interest Author declares there is no conflict of interest.

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