June 13, 2016
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VIDEO: FLAT-SUGAR investigators continue to explore role of glucose variability in diabetes-related complications

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NEW ORLEANS — In this video exclusive, Irl B. Hirsch, MD, professor of medicine at the University of Washington in Seattle, discusses the motivations behind the FLAT-SUGAR study, new data since the report at last year’s American Diabetes Association Scientific Sessions, and plans for the future.

The goal of the complex proof-of-concept study was to determine the possibility of maintaining steady HbA1c while demonstrating differences in glucose variability with two different treatment regimens. Investigators compared a basal-bolus insulin regimen with a regimen of basal insulin plus the GLP-1 receptor agonist Byetta (exenatide, AstraZeneca). Results showed a significant reduction of glucose variability with exenatide along with a mean weight loss of 5.5 kg. The researchers also observed a toward for less hypoglycemia and reduction of some inflammatory markers in the exenatide group.

Hirsch said it remains unclear whether improvements in inflammatory markers were the result of weight loss, reduction in glucose variability or the effect of a GLP-1 receptor agonist alone.

So, he asked, is glucose variability a risk factor for diabetes-related complications?

“The reality is, I don’t know,” Hirsch said. “I want to ... continue to test the hypothesis because we know it isn’t all related to HbA1c.”