Selected Late-breaking Abstracts

Report by Joelle Escoffery, PhD

A number of late-breaking abstracts relevant to the management of diabetes are presented here.

2-LB: A randomized Controlled Study of a Transcutaneous, Real-time Continuous Sensor Demonstrates Improvement in Glycemic Control

Jovanovic L, Zisser H, Schwartz S, Bailey T, Kaplan R.

The efficacy and safety of a continuous glucose monitoring sensor (DexCom, Inc) was evaluated in subjects with both type 1 and type 2 diabetes. The sensor was worn in abdominal s.q. tissue, and patients were randomized to one of two groups: a control group that was blinded to all glucose data, and a display group that was blinded to glucose data initially and then given the opportunity to see current glucose level, trend graphs for a variety of time intervals, and high and low glucose alerts. Results showed that the device was relatively accurate (median Absolute Relative Difference = 15.9%) and that glycemic profiles were improved without physician guidance. Further, the display group had better glycemic profiles than the control group. The display group improved their glycemic control after only 6 days and decreased both high and low blood glucose frequencies compared with the control group.

6-LB: A Randomised Controlled Trial of Insulin Infusion Therapy for Myocardial Infarction: The HI-5 Study

Cheung W, Wong V, McClean M.

Because the data on insulin use among myocardial infarction patients have been equivocal, this study was conducted to test whether a variable rate insulin with dextrose infusion protocol designed to reduce hyperglycemia was an effective way to improve outcomes following myocardial infarction. Subjects were randomly assigned a control group that received subcutaneous insulin injections only if hyperglycemia was present or the insulin with dextrose infusion targeting blood glucose levels to between 4 mmol/L and10 mmol/L). Results demonstrated that the variable infusion protocol did not reduce mortality, but there was a significant relationship between blood glucose levels and mortality during the first 24 hours.

9-LB: Combination Therapy With Insulin Glargine (GLAR) Plus Metformin (MET) but not GLAR Plus Sulfonylurea (SU) Provides Similar Glycemic Control to Triple Oral Combination (3OA) in Patients with Type 2 Diabetes (T2D) Failing Oral Agents

Hollander P, Sugimoto D, Kilo C, Harris A, Vlajnic A.

Existing thiazoladinedione (TZD)/MET and SU/MET treatment regimens not providing adequate glycemic control were randomized to one of 3 conditions: 3OA, glargine plus MET, or glargine plus SU. Results demonstrated that glargine plus MET was more effective than glargine plus SU and as effective as 3OA.

10-LB: Improved Glycemic Control with Insulin Glargine (GLAR) vs Pioglitazone (PIO) as Add-on Therapy in Patients with Type 2 Diabetes (T2D) Uncontrolled on Sulfonylurea (SU) or Metformin (MET) Monotherapy

Meneghini LF, Schwartz S, Rak ES, Harris A, Strange P.

This randomized, parallel-group, 2-arm, open label study evaluated the effects of adding GLAR or PIO to existing uncontrolled monotherapy with either SU or MET. Results demonstrated that the addition of GLAR was associated with a greater reduction in A1C than the addition of PIO.