Abstract | BACKGROUND: Achieving euglycaemia by continuous subcutaneous insulin infusion (CSII) therapy alone has been shown to restore β-cell function in patients with newly diagnosed type 2 diabetes. However, the efficacy has not been evaluated in patients with non-newly diagnosed type 2 diabetes and suboptimal glycaemic control. METHODS: Of the 1220 patients with type 2 diabetes who began CSII therapy from March 2000 to March 2007, we retrospectively selected patients using the following inclusion criteria: glycosylated haemoglobin (HbA1c ) ≥ 7.0%, diabetes duration ≥ 1 year before CSII therapy, and duration of CSII therapy ≥ 6 months. We evaluated sequential changes in HbA1c and serum C-peptide levels measured at a 6- to 12-month intervals during CSII therapy. RESULTS: In the 521 subjects included in this study [median diabetes duration 10 years; interquartile range (IQR) 6.0-17.0; CSII therapy ≤ 30 months], median HbA1c decreased from 8.7% (IQR 7.7-10.0) at baseline to 6.3% (IQR 5.9-6.9) after 6 months of CSII therapy (p < 0.0001). During the subsequent 24 months, median HbA1c levels were maintained between 6.3% and 6.5% (p < 0.0001 for all time points vs baseline). At 12 months after CSII therapy, median C-peptide levels began to increase compared with baseline (fasting level 23% increase, p < 0.0001; 2-h postprandial level 26% increase, p = 0.022), and the increase was maintained at 30 months (fasting level 39%; 2-h postprandial level 53%; p < 0.0001 for all vs baseline). CONCLUSIONS: β-Cell function was significantly improved in patients with non-newly diagnosed and suboptimally controlled type 2 diabetes after achieving and maintaining optimal glycaemic control with long-term CSII therapy alone.
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Authors | Soo-Bong Choi, Jun-Ho Lee, Ju-Han Lee, Seonguk Kim, Sang-Don Han, Ick-Hee Kim, Yun-Hee Noh |
Journal | Diabetes/metabolism research and reviews
(Diabetes Metab Res Rev)
Vol. 29
Issue 6
Pg. 473-82
(Sep 2013)
ISSN: 1520-7560 [Electronic] England |
PMID | 23592489
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2013 John Wiley & Sons, Ltd. |
Chemical References |
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Topics |
- Aged
- Blood Glucose
(drug effects, metabolism)
- Diabetes Mellitus, Type 2
(blood, drug therapy, physiopathology)
- Female
- Humans
- Infusions, Subcutaneous
- Insulin
(administration & dosage)
- Insulin Infusion Systems
- Insulin Resistance
- Insulin-Secreting Cells
(drug effects, physiology)
- Male
- Middle Aged
- Retrospective Studies
- Treatment Outcome
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