Insulin requirement profiles of short-term intensive insulin therapy in patients with newly diagnosed type 2 diabetes and its association with long-term glycemic remission

2015 ◽  
Vol 108 (2) ◽  
pp. 250-257 ◽  
Author(s):  
Liehua Liu ◽  
Weijian Ke ◽  
Xuesi Wan ◽  
Pengyuan Zhang ◽  
Xiaopei Cao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Intensive Insulin Therapy ◽  
Insulin Requirement ◽  
Newly Diagnosed ◽  
Short Term

scholarly journals Hypoglycemia during Short-Term Intensive Insulin Therapy and Its Association with Long-Term Glycemic Remission in Patients with Newly Diagnosed Type 2 Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Lijuan Xu ◽  
Pengyuan Zhang ◽  
Zhimin Huang ◽  
Liangying Zhong ◽  
Hai Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Dose Reduction ◽  
Intensive Insulin Therapy ◽  
Insulin Dose ◽  
Newly Diagnosed ◽  
Short Term ◽  
Drug Free

Background. Short-term intensive insulin therapy induces long-term glycemic remission in half of patients with newly diagnosed type 2 diabetes. The concomitant hypoglycemia needs further analysis. Methods. We collected data from three randomized trials conducted with the same inclusion and exclusion criteria at our institution from 2002 to 2015. Continuous subcutaneous insulin infusion (CSII) was provided to achieve the glycemic goals within a week and then maintained for 14 days. Hypoglycemia episodes during short-term treatment and the one-year drug-free glycemic remission were observed. Results. A total of 244 patients were included. The per day episode of mild hypoglycemia (3.0-3.9 mmol/L) was higher in the remission group than in the nonremission group (0.26±0.20 vs. 0.18±0.21, P=0.005). However, a moderate hypoglycemia episode (<3.0 mmol/L) per day was insignificantly lower in the remission group (0.02±0.04 vs. 0.03±0.04, P=0.221). After the cessation of insulin treatment, both acute insulin response (491.35 (801.89) vs. 370.22 (542.29), P=0.028) and homeostasis model assessment of insulin resistance (2.08 (2.04) vs. 2.48 (2.32), P=0.038) were more improved in the remission group than in the nonremission group. Logistic regression analysis showed that mild hypoglycemic episodes during short-term CSII treatment were independently related to a long-term glycemic remission (OR=2.18, 95% CI 1.02~4.70). Stratified analysis demonstrated that episodes during the continuing insulin dose reduction period played a substantial role. Conclusions. Mild hypoglycemic episodes during the continuing insulin dose reduction period indicate a long-term drug-free euglycemic remission in patients with newly diagnosed type 2 diabetes. However, the insulin dosage should be reduced even more quickly in the future treatment to decrease the potential harms.

scholarly journals The effect of short-term intensive insulin therapy in newly-diagnosed Type-2 diabetic patients

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Cengiz Karacaer ◽  
Taner Demirci ◽  
Hasret Cengiz ◽  
Ceyhun Varim ◽  
Ali Tamer
Keyword(s):  
Glycemic Control ◽  
Insulin Therapy ◽  
Intensive Insulin Therapy ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Short Term ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Objectives: We aimed to determine the effect of short-term intensive insulin therapy (SIIT) on long-term glycemic control in newly-diagnosed Type-2 diabetes mellitus (nT2DM) patients. Methods: In this retrospectively study conducted at Sakarya University Medical Faculty Training and Research Hospital Outpatient Clinic between 2016 and 2019, 65 nT2DM patients were enrolled soon after their SIIT was initiated and were followed for at least a year. Intensive insulin treatment was discontinued after three or 12 months in a total of 65 (23–73-year-old) patients who had been newly diagnosed with T2DM. Intensive insulin therapy was discontinued when glycemic control and the target Glycated Hemoglobin (HbA1c) level had been attained, after which oral anti-diabetic drug (OAD), long-term insulin, and diet therapies were pursued. Results: There was a significant decrease in mean HbA1c from 11.25±1.96% to 6.67±1.07%. Fasting plasma glucose (FPG) was found to be an independent predictor of whether intensive insulin therapy could be discontinued after three months in a model that included FPG, HbA1c, and body mass index measured at baseline. Patients with FPG >13.8 mmol/L were 7.6 times more likely to require intensive insulin therapy beyond three months. There were significant decreases in HbA1c and low-density lipoprotein-cholesterol concentration, but no change in C-peptide between baseline and 3 months of therapy. Conclusion: These results demonstrate that in nT2DM patients, intensive insulin therapy could be effective on long-term glycemic control and high FPG prior to three months of SIIT may predict poor long-term glycemic control. doi: https://doi.org/10.12669/pjms.37.7.4013 How to cite this:Karacaer C, Demirci T, Cengiz H, Varim C, Tamer A. The effect of short-term intensive insulin therapy in newly-diagnosed Type-2 diabetic patients. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4013 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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