Newly Diagnosed Type 2 Initiated on Basal Insulin with Oral Antidiabetic Med

In newly diagnosed type 2 diabetes, therapy with oral antidiabetes drugs plus basal insulin (OAD+insulin) has had favorable outcomes on recovery and maintenance of β-cell function and protracted glycemic remission compared to treatment with OAD alone….

For the study, 129 patients, aged 35-50 years, were enrolled between June 2005 and June 2009. For initial correction of hyperglycemia, patients with fasting plasma glucose greater than 162mg/dL.( ≥9.0mmol/L) and HbA1c≥9.0%, were randomly assigned to therapy with OAD+insulin or OAD alone. Treatment was stopped after normoglycemia was maintained for three months. Patients then followed up with diet and physical exercise. Blood glucose, HbA1c and insulin were measured prior to treatment and at one-year follow-up.

The results of the study showed that more patients achieved target glycemic control in the OAD+insulin group [98.3% (58 of 59)] in less time [(10.4±2.5) days] than those in the OAD group [95.7% (67 of 70) and (12.4±3.4) days].  Also, at one-year follow-up, more patients maintained target glycemia without any drugs in the OAD+insulin group than in the OAD group [37.9% (22 of 58) vs. 20.9% (14 of 67)].  Both treatments improved HOMA-β and 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].  OAD+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].

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