Relationship between A1C and fasting plasma glucose in dysglycemia or type 2 diabetes: an analysis of baseline data from the ORIGIN trial

Ramachandran A, Riddle MC, Kabali C, Gerstein HC; for the ORIGIN Investigators.
Diabetes Care. 2012;35:749-753. 

This overview was created by KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional/commercial interest. 

The Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial is a global trial assessing whether targeting normal FPG levels with basal insulin glargine reduces cardiovascular outcomes compared with standard care among people taking 0 or 1 oral antidiabetes drugs (OADs).  

Participants’ baseline A1C and FPG were analyzed to:  

  • Clarify the relationship between A1C and FPG among those with moderate dysglycemia (A1C 5.6-9%) and additional cardiovascular disease risk factors  
  • Determine whether OAD use alters this relationship  
  • Assess whether this relationship differs among those from different geographic regions or of different ethnicities  

Baseline characteristics of study participants (N=12,527) were as follows:  

  • Majority were male (n=8,146; 65%) and had established diabetes (n=10,290; 82.1%)  
  • Mean age: 63.6 years  
  • Mean BMI: 29.8 kg/m2  
  • Mean FPG, A1C
    • On OAD: 136.8 mg/dL, 6.7%  
    • Not on OAD: 124.2 mg/dL, 6.3%  
     
  • 48.4% from Europe; 30.7% from South America, 10.4% from North America; 10.4% from Pacific Rim  
  • 59% White; 25.2% Latin; 10% Asian; 3.3% Black; 2.5% other  

Results:
A strong relationship between FPG in the range of 100.8-162 mg/dL and corresponding A1C was found across different geographic regions and ethnicities.  

A smaller increase in A1C per FPG unit increase occurred for people taking OAD compared with those not taking OAD  

  • At FPG levels of 100.8-162 mg/dL and without OAD use, for every 18 mg/dL higher FPG, A1C increased by an average of 0.43% (P<0.0001)  
  • With OAD use, the corresponding average A1C increase was 0.26% (P<0.0001)   

Don’t miss slides on the ORIGIN study in our Slide Library: 

ORIGIN: Design  

ORIGIN Omega-3 Fatty Acid Trial: Design  

ORIGIN Omega-3 Fatty Acid Trial: Primary and Secondary Outcomes  

ORIGIN Omega-3 Fatty Acid Trial: Additional Outcomes  

ORIGIN Omega-3 Fatty Acid Trial: Eligibility Criteria and Trial Profile  

ORIGIN Omega-3 Fatty Acid Trial: Baseline Characteristics (1 of 2)  

ORIGIN Omega-3 Fatty Acid Trial: Baseline Characteristics (2 of 2)  

ORIGIN Omega-3 Fatty Acid Trial: Primary Outcome—CV Death  

ORIGIN Omega-3 Fatty Acid Trial: Secondary Outcomes  

ORIGIN Omega-3 Fatty Acid Trial: Mean Change in Lipids  

ORIGIN Omega-3 Fatty Acid Trial: Conclusions  

ORIGIN Glargine Trial: Design  

ORIGIN Glargine Trial: Primary and Secondary Outcomes  

ORIGIN Glargine Trial: Eligibility Criteria and Trial Profile  

ORIGIN Glargine Trial: Baseline Characteristics (1 of 2)  

ORIGIN Glargine Trial: Baseline Characteristics (2 of 2)  

ORIGIN Glargine Trial: Insulin Use During Trial  

ORIGIN Glargine Trial: A1C, FPG During Trial  

ORIGIN Glargine Trial: First Coprimary Outcome—CV Death, Nonfatal MI, or Nonfatal Stroke 

ORIGIN Glargine Trial: Second Coprimary Outcome—CV Death, Nonfatal MI, Nonfatal Stroke, Revascularization, or Hospitalized Heart Failure  

ORIGIN Glargine Trial: Secondary Outcomes  

ORIGIN Glargine Trial: Secondary Outcome—Cancer Incidence  

ORIGIN Glargine Trial: Hypoglycemia  

ORIGIN Glargine Trial: Weight Change  

ORIGIN Glargine Trial: Conclusions  

 This overview was created by KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional/commercial interest. 

 

Last Modified: 11/18/2013