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Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment
Article de En | WPRIM | ID: wpr-154202
Bibliothèque responsable: WPRO
ABSTRACT
BACKGROUND: There were a limited number of studies about β-cell function after insulin initiation in patients exposed to long durations of sulfonylurea treatment. In this study, we aimed to evaluate the recovery of β-cell function and the efficacy of concurrent sulfonylurea use after the start of long-acting insulin. METHODS: In this randomized controlled study, patients with type 2 diabetes mellitus (T2DM), receiving sulfonylurea for at least 2 years with glycosylated hemoglobin (HbA1c) >7%, were randomly assigned to two groups: sulfonylurea maintenance (SM) and sulfonylurea reduction (SR). Following a 75-g oral glucose tolerance test (OGTT), we administered long-acting basal insulin to the two groups. After a 6-month follow-up, we repeated the OGTT. RESULTS: Among 69 enrolled patients, 57 completed the study and were analyzed: 31 in the SM and 26 in the SR group. At baseline, there was no significant difference except for the longer duration of diabetes and lower triglycerides in the SR group. After 6 months, the HbA1c was similarly reduced in both groups, but there was little difference in the insulin dose. In addition, insulin secretion during OGTT was significantly increased by 20% to 30% in both groups. A significant weight gain was observed in the SM group only. The insulinogenic index was more significantly improved in the SR group. CONCLUSION: Long-acting basal insulin replacement could improve the glycemic status and restore β-cell function in the T2DM patients undergoing sulfonylurea-based treatment, irrespective of the sulfonylurea dose reduction. The dose reduction of the concurrent sulfonylurea might be beneficial with regard to weight grain.
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Texte intégral: 1 Indice: WPRIM Sujet Principal: Triglycéride / Hémoglobine glyquée / Prise de poids / Études de suivi / Insuline à longue durée d'action / Diabète de type 2 / Hyperglycémie provoquée / Insuline Type d'étude: Clinical_trials / Observational_studies / Prognostic_studies Limites du sujet: Humans langue: En Texte intégral: Diabetes & Metabolism Journal Année: 2016 Type: Article
Texte intégral: 1 Indice: WPRIM Sujet Principal: Triglycéride / Hémoglobine glyquée / Prise de poids / Études de suivi / Insuline à longue durée d'action / Diabète de type 2 / Hyperglycémie provoquée / Insuline Type d'étude: Clinical_trials / Observational_studies / Prognostic_studies Limites du sujet: Humans langue: En Texte intégral: Diabetes & Metabolism Journal Année: 2016 Type: Article