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

Intensive insulin & newly-diagnosed type 2 diabet

  • Cengiz Karacaer sakarya university research and training hospital
  • Taner Demirci
  • Hasret Cengiz
  • Ceyhun Varim
  • Ali Tamer
Keywords: Intensive insulin, Diabetes mellitus, Glycemic control, Beta-cell recovery, HbA1c

Abstract

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.

Author Biographies

Taner Demirci

Assistant Professor, Department of Endocrinology and Metabolism, Sakarya University Research and Education Hospital, Sakarya, Turkey. Orcid no: 0000-0002-9579-4530    tnrdemirci@gmail.com 

Hasret Cengiz

Hasret Cengiz: Medical Doctor, Department of Internal Medicine, Sakarya University Medicine Faculty, Sakarya, Turkey. Orcid no: 0000-0002-5216-3368  drhasretc@gmail.com

Ali Tamer

Professor Department of Internal Medicine, Sakarya University Medicine Faculty, Sakarya, Turkey. Orcid no: 0000-0003-2005-0737 atamer2002@yahoo.com

Published
2021-09-06
How to Cite
Karacaer, C., Demirci, T., Cengiz, H., Varim, C., & Tamer, A. (2021). The effect of short-term intensive insulin therapy in newly-diagnosed Type-2 diabetic patients. Pakistan Journal of Medical Sciences, 37(7). https://doi.org/10.12669/pjms.37.7.4013
Section
Original Articles