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Publications

Journal Article Ahead of print

PubMed: 42554785 DOI: 10.1007/s13300-026-01903-2

Glycemic Patterns Assessed by Continuous Glucose Monitoring in People with Type 2 Diabetes Treated with Insulin Glargine 100 U/mL in Primary Care: The GPDetect Study.

Diabetes Ther

Authors: Virginia Bellido, Ana Cebrián, Cristóbal Morales, Alberto S de Las Hazas, Alfonso Soto-Gonzalez, Carla Morer-Liñan, José M Borrachero, Gabriel Cuatrecases, Elena L García, Judith López-Fernández, Silvia Lozano-García, Álvaro M Bayón, Cristina M Niño-Azcarate, Oscar Laclaustra, Paulina Fuentealba

Affiliations

  • Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Avenida Manuel Siurot s/n, 41013, Seville, Spain.
  • Centro de Salud de Cartagena Casco Antiguo, Murcia, Spain.
  • Primary Care Research Group, Murcian Health Service (SMS), IMIB-Arrixaca (Murcia Institute for Biomedical Research), Murcia, Spain.
  • Hospital Vithas Sevilla, Seville, Spain.
  • Centro de Salud García Noblejas, Madrid, Spain.
  • Complejo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Spain.
  • CAP Río de Janeiro, Barcelona, Spain.
  • Centro de Salud Cartagena/Isaac Peral, Murcia, Spain.
  • CAP Sarrià, Barcelona, Spain.
  • Centro de Salud Aldaia, Valencia, Spain.
  • Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
  • Consultorio Bollullos De La Mitación, Seville, Spain.
  • Gerencia de Atención Primaria de Salamanca, Salamanca, Spain.
  • Centro de Salud Ofra - Miramar, Santa Cruz de Tenerife, Spain.
  • Sanofi Spain, Barcelona, Spain.

Abstract

INTRODUCTION

Hypoglycemia is a common complication in people with type 2 diabetes mellitus (T2DM) treated with basal insulin, yet its true prevalence in real-world primary care remains underexplored. This study used blinded continuous glucose monitoring (CGM) to assess glycemic patterns in patients with T2DM on basal insulin-supported oral therapy (BOT) with insulin glargine 100 U/mL (Gla-100) in Spain.

METHODS

GPDetect was a prospective, multicenter, observational study in adults with T2DM treated with Gla-100 for ≥ 6 months in primary care. Participants underwent 14 days of blinded CGM (FreeStyle Libre ® Pro iQ ®). The primary objective of the present study was to estimate the proportion of patients with T2DM treated with Gla-100 whose TBR (glucose < 70 mg/dL) exceeded the internationally recommended threshold of 4%. Secondary endpoints included time in range (TIR), time above range (TAR), episodes of clinically significant hypoglycemia (< 54 mg/dL), cognitive function (MMSE), and fear of hypoglycemia (EsHFS).

RESULTS

Among 136 patients (mean age 69 years), 16.9% had TBR > 4%, with a higher prevalence at night (23.5%) than during the day (12.5%). Clinically significant hypoglycemia (< 54 mg/dL > 1%) occurred in 8.8% of patients. Hyperglycemia was common: 46.3% spent > 25% of the day between 181-250 mg/dL, and 28.7% spent time > 250 mg/dL. Only 55.9% achieved TIR ≥ 70%. Patients receiving SGLT2i had lower mean glucose and EsHFS scores. Cognitive impairment (MMSE < 23) was associated with longer hypoglycemia duration.

CONCLUSIONS

Blinded CGM revealed a relevant burden of unrecognized hypoglycemia-particularly nocturnal-as well as daytime hyperglycemia in patients with T2DM treated with Gla-100 in primary care. These results support the clinical value of CGM in informing treatment decisions and improving individualized diabetes management.

MeSH

Diabetes Mellitus, Insulin Glargine, Insulin, Prevalence, Therapeutics, Hypoglycemia, Diabetes Mellitus, Type 2, Continuous Glucose Monitoring