Highlights
- •There is a decline of daily insulin dose after euglycemia achieved.
- •The decrement of daily insulin dose is related to reduction of insulin resistance during the therapy.
- •Patients with lowest decline of insulin dose had higher risk of hyperglycemic relapse.
Abstract
Aims
To investigate the insulin requirement profiles during short-term intensive continuous
subcutaneous insulin infusion (CSII) in patients with newly diagnosed type 2 diabetes
and its relationship with long-term glycemic remission.
Methods
CSII was applied in 104 patients with newly diagnosed type 2 diabetes. Daily insulin
doses were titrated and recorded to achieve and maintain euglycemia for 2 weeks. Measurements
of blood glucose, lipid profiles as well as intravenous glucose tolerance tests were
performed before and after the therapy. Afterwards, patients were followed up for
1 year.
Results
Total daily insulin dose (TDD) was 56.6 ± 16.1 IU at the first day when euglycemia was achieved (TDD-1). Thereafter, TDD progressively
decreased at a rate of 1.4 ± 1.0 IU/day to 36.2 ± 16.5 IU at the end of the therapy. TDD-1 could be estimated with body weight, FPG, triglyceride
and waist circumference in a multiple linear regression model. Decrement of TDD after
euglycemia was achieved (ΔTDD) was associated with reduction of HOMA-IR (r = 0.27, P = 0.008) but not with improvement in β cell function. Patients in the lower tertile
of ΔTDD had a significantly higher risk of hyperglycemia relapse than those in the
upper tertile within 1 year (HR 3.4, 95%CI [1.4, 8.4], P = 0.008).
Conclusions
There is a steady decline of TDD after euglycemia is achieved in patients with newly
diagnosed type 2 diabetes treated with CSII, and ΔTDD is associated with a better
long-term glycemic outcome.
Keywords
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Article info
Publication history
Published online: February 21, 2015
Accepted:
February 13,
2015
Received in revised form:
December 23,
2014
Received:
August 25,
2014
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
