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Effects of a combination of oral anti-diabetes drugs with basal insulin therapy on β-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes.
Diabetes Metab Res Rev. 2012 Mar; 28(3):236-40.DM

Abstract

BACKGROUND

Oral anti-diabetes drugs plus basal insulin (OAD + insulin) therapy in patients with newly diagnosed type 2 diabetes might improve β-cell function and result in extended glycaemic remission. This randomised trial compared the effect on β-cell function and diabetes remission rate between oral drug alone or with addition of basal insulin.

METHODS

One hundred and twenty-nine patients, aged 35-50 years, were enrolled between June 2005 and June 2009. For initial correction of hyperglycaemia, patients with fasting plasma glucose ≥9.0 mmol/L and HbA(1c) ≥ 9.0%, were randomly assigned to therapy with oral drugs + insulin or oral drugs alone. Treatment was stopped after normoglycaemia was maintained for 3 months. Patients were then followed-up with diet and physical exercise. Blood glucose, HbA(1c) and insulin were measured prior to treatment and at 1-year follow-up.

RESULTS

More patients achieved target glycaemic control in the oral drugs + insulin group [98.3% (58 of 59)] in less time [(10.4 ± 2.5) days] than those in the oral drug group [95.7% (67 of 70) and (12.4 ± 3.4) days]. At 1-year follow-up, more patients maintained target glycaemia without any drugs in the oral drug + insulin group than in the oral drug group [37.9% (22 of 58) vs 20.9% (14 of 67)]. Both treatments improved homeostasis model assessment-β (HOMA-β) and homeostasis model assessment-insulin resistance (HOMA-IR) significantly. They had similar effects on insulin resistance [lg(HOMA-IR): (0.50 ± 0.09) vs (0.48 ± 0.09), p = 0.23]. However, oral drugs + insulin could recover β-cell function much more than OAD alone could [lg(HOMA-β): (2.17 ± 0.14) vs (2.11 ± 0.13), p = 0.03].

CONCLUSION

In newly diagnosed type 2 diabetes, therapy with oral drugs + insulin has had favourable outcomes on recovery and maintenance of β-cell function and protracted glycaemic remission compared with treatment with oral drugs alone.

Authors+Show Affiliations

Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21898754

Citation

Mu, Pan-wei, et al. "Effects of a Combination of Oral Anti-diabetes Drugs With Basal Insulin Therapy On Β-cell Function and Glycaemic Control in Patients With Newly Diagnosed Type 2 Diabetes." Diabetes/metabolism Research and Reviews, vol. 28, no. 3, 2012, pp. 236-40.
Mu PW, Chen YM, Lu HY, et al. Effects of a combination of oral anti-diabetes drugs with basal insulin therapy on β-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes. Diabetes Metab Res Rev. 2012;28(3):236-40.
Mu, P. W., Chen, Y. M., Lu, H. Y., Wen, X. Q., Zhang, Y. H., Xie, R. Y., Shu, J., Wang, M. M., & Zeng, L. Y. (2012). Effects of a combination of oral anti-diabetes drugs with basal insulin therapy on β-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes. Diabetes/metabolism Research and Reviews, 28(3), 236-40. https://doi.org/10.1002/dmrr.1292
Mu PW, et al. Effects of a Combination of Oral Anti-diabetes Drugs With Basal Insulin Therapy On Β-cell Function and Glycaemic Control in Patients With Newly Diagnosed Type 2 Diabetes. Diabetes Metab Res Rev. 2012;28(3):236-40. PubMed PMID: 21898754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of a combination of oral anti-diabetes drugs with basal insulin therapy on β-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes. AU - Mu,Pan-wei, AU - Chen,Yan-ming, AU - Lu,Hong-yun, AU - Wen,Xing-qiao, AU - Zhang,Yan-hua, AU - Xie,Ru-ying, AU - Shu,Jiong, AU - Wang,Man-man, AU - Zeng,Long-yi, PY - 2011/9/8/entrez PY - 2011/9/8/pubmed PY - 2012/6/29/medline SP - 236 EP - 40 JF - Diabetes/metabolism research and reviews JO - Diabetes Metab Res Rev VL - 28 IS - 3 N2 - BACKGROUND: Oral anti-diabetes drugs plus basal insulin (OAD + insulin) therapy in patients with newly diagnosed type 2 diabetes might improve β-cell function and result in extended glycaemic remission. This randomised trial compared the effect on β-cell function and diabetes remission rate between oral drug alone or with addition of basal insulin. METHODS: One hundred and twenty-nine patients, aged 35-50 years, were enrolled between June 2005 and June 2009. For initial correction of hyperglycaemia, patients with fasting plasma glucose ≥9.0 mmol/L and HbA(1c) ≥ 9.0%, were randomly assigned to therapy with oral drugs + insulin or oral drugs alone. Treatment was stopped after normoglycaemia was maintained for 3 months. Patients were then followed-up with diet and physical exercise. Blood glucose, HbA(1c) and insulin were measured prior to treatment and at 1-year follow-up. RESULTS: More patients achieved target glycaemic control in the oral drugs + insulin group [98.3% (58 of 59)] in less time [(10.4 ± 2.5) days] than those in the oral drug group [95.7% (67 of 70) and (12.4 ± 3.4) days]. At 1-year follow-up, more patients maintained target glycaemia without any drugs in the oral drug + insulin group than in the oral drug group [37.9% (22 of 58) vs 20.9% (14 of 67)]. Both treatments improved homeostasis model assessment-β (HOMA-β) and homeostasis model assessment-insulin resistance (HOMA-IR) significantly. They had similar effects on insulin resistance [lg(HOMA-IR): (0.50 ± 0.09) vs (0.48 ± 0.09), p = 0.23]. However, oral drugs + insulin could recover β-cell function much more than OAD alone could [lg(HOMA-β): (2.17 ± 0.14) vs (2.11 ± 0.13), p = 0.03]. CONCLUSION: In newly diagnosed type 2 diabetes, therapy with oral drugs + insulin has had favourable outcomes on recovery and maintenance of β-cell function and protracted glycaemic remission compared with treatment with oral drugs alone. SN - 1520-7560 UR - https://www.unboundmedicine.com/medline/citation/21898754/Effects_of_a_combination_of_oral_anti_diabetes_drugs_with_basal_insulin_therapy_on_β_cell_function_and_glycaemic_control_in_patients_with_newly_diagnosed_type_2_diabetes_ L2 - https://doi.org/10.1002/dmrr.1292 DB - PRIME DP - Unbound Medicine ER -