A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 Diabetes
Aims. Basal insulin plus oral hypoglycemic agents (OHAs) has not been investigated for early intensive antihyperglycemic treatment in people with newly diagnosed type 2 diabetes. This study is aimed at comparing the short-term (over a period of 12 days) effects of basal insulin glargine plus OHAs an...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2018/2791584 |
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| author | Shuo Lin Mu Chen Wanling Chen Keyi Lin Panwei Mu Bilian Zhu Wen Xu Manman Wang Jianping Weng Longyi Zeng |
| author_facet | Shuo Lin Mu Chen Wanling Chen Keyi Lin Panwei Mu Bilian Zhu Wen Xu Manman Wang Jianping Weng Longyi Zeng |
| author_sort | Shuo Lin |
| collection | DOAJ |
| description | Aims. Basal insulin plus oral hypoglycemic agents (OHAs) has not been investigated for early intensive antihyperglycemic treatment in people with newly diagnosed type 2 diabetes. This study is aimed at comparing the short-term (over a period of 12 days) effects of basal insulin glargine plus OHAs and continuous subcutaneous insulin infusion (CSII) on glycemic control and beta-cell function in this setting. Methods. An open-label parallel-group study. Newly diagnosed hospitalized patients with type 2 diabetes and fasting plasma glucose (FPG) ≥11.1 mmol/L or glycated hemoglobin (HbA1c) ≥9% (75 mmol/mol) were randomized to CSII or insulin glargine in combination with metformin and gliclazide. The primary outcome measure was the mean amplitude of glycemic excursions (MAGE), and secondary endpoints included time to reach glycemic control target (FPG < 7 mmol/L and 2-hour postprandial plasma glucose < 10 mmol/L), markers of β-cell function, and hypoglycemia. Results. Subjects in the CSII (n=35) and basal insulin plus OHA (n=33) groups had a similar significant reduction from baseline to end of treatment in glycated albumin (−6.44 ± 3.23% and− 6.42 ± 3.56%, P=0.970). Groups A and B have comparable time to glycemic control (3.6 ± 1.2 days and 4.0 ± 1.4 days), MAGE (3.40 ± 1.40 mmol/L vs. 3.16 ± 1.38 mmol/L; p=0.484), and 24-hour mean blood glucose (7.49 ± 0.96 mmol/L vs. 7.02 ± 1.03 mmol/L). Changes in the C-peptide reactivity index, the secretory unit of islet in transplantation index, and insulin secretion-sensitivity index-2 indicated a greater β-cell function improvement with basal insulin plus OHAs versus CSII. Conclusions. Short-term insulin glargine plus OHAs may be an alternative to CSII for initial intensive therapy in people with newly diagnosed type 2 diabetes. |
| format | Article |
| id | doaj-art-b35002e17b06480e8df9e38e1d5a6d95 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-b35002e17b06480e8df9e38e1d5a6d952025-02-03T05:52:03ZengWileyJournal of Diabetes Research2314-67452314-67532018-01-01201810.1155/2018/27915842791584A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 DiabetesShuo Lin0Mu Chen1Wanling Chen2Keyi Lin3Panwei Mu4Bilian Zhu5Wen Xu6Manman Wang7Jianping Weng8Longyi Zeng9Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Lu, Guangzhou 510630, ChinaRespiratory Department, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, ChinaDepartment of Endocrinology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510000, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Lu, Guangzhou 510630, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Lu, Guangzhou 510630, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Lu, Guangzhou 510630, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Lu, Guangzhou 510630, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Lu, Guangzhou 510630, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Lu, Guangzhou 510630, ChinaDepartment of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Lu, Guangzhou 510630, ChinaAims. Basal insulin plus oral hypoglycemic agents (OHAs) has not been investigated for early intensive antihyperglycemic treatment in people with newly diagnosed type 2 diabetes. This study is aimed at comparing the short-term (over a period of 12 days) effects of basal insulin glargine plus OHAs and continuous subcutaneous insulin infusion (CSII) on glycemic control and beta-cell function in this setting. Methods. An open-label parallel-group study. Newly diagnosed hospitalized patients with type 2 diabetes and fasting plasma glucose (FPG) ≥11.1 mmol/L or glycated hemoglobin (HbA1c) ≥9% (75 mmol/mol) were randomized to CSII or insulin glargine in combination with metformin and gliclazide. The primary outcome measure was the mean amplitude of glycemic excursions (MAGE), and secondary endpoints included time to reach glycemic control target (FPG < 7 mmol/L and 2-hour postprandial plasma glucose < 10 mmol/L), markers of β-cell function, and hypoglycemia. Results. Subjects in the CSII (n=35) and basal insulin plus OHA (n=33) groups had a similar significant reduction from baseline to end of treatment in glycated albumin (−6.44 ± 3.23% and− 6.42 ± 3.56%, P=0.970). Groups A and B have comparable time to glycemic control (3.6 ± 1.2 days and 4.0 ± 1.4 days), MAGE (3.40 ± 1.40 mmol/L vs. 3.16 ± 1.38 mmol/L; p=0.484), and 24-hour mean blood glucose (7.49 ± 0.96 mmol/L vs. 7.02 ± 1.03 mmol/L). Changes in the C-peptide reactivity index, the secretory unit of islet in transplantation index, and insulin secretion-sensitivity index-2 indicated a greater β-cell function improvement with basal insulin plus OHAs versus CSII. Conclusions. Short-term insulin glargine plus OHAs may be an alternative to CSII for initial intensive therapy in people with newly diagnosed type 2 diabetes.http://dx.doi.org/10.1155/2018/2791584 |
| spellingShingle | Shuo Lin Mu Chen Wanling Chen Keyi Lin Panwei Mu Bilian Zhu Wen Xu Manman Wang Jianping Weng Longyi Zeng A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 Diabetes Journal of Diabetes Research |
| title | A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 Diabetes |
| title_full | A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 Diabetes |
| title_fullStr | A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 Diabetes |
| title_full_unstemmed | A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 Diabetes |
| title_short | A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 Diabetes |
| title_sort | randomized trial of insulin glargine plus oral hypoglycemic agents versus continuous subcutaneous insulin infusion to treat newly diagnosed type 2 diabetes |
| url | http://dx.doi.org/10.1155/2018/2791584 |
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