scholarly journals Improvement in insulin sensitivity following intensive insulin therapy and association of glucagon with long-term diabetes remission

2016 ◽  
Vol 44 (6) ◽  
pp. 1543-1550 ◽  
Author(s):  
Bo Zhang ◽  
Yan-yan Chen ◽  
Zhao-jun Yang ◽  
Xin Wang ◽  
Guang-wei Li
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Intensive Insulin Therapy ◽  
Insulin Response ◽  
Newly Diagnosed ◽  
Intravenous Glucose

Objective To investigate the role of the acute glucagon response in the long-term remission of newly diagnosed type 2 diabetes mellitus following short-term intensive insulin therapy (IIT). Methods Ten patients with newly diagnosed type 2 diabetes mellitus received IIT. Intravenous glucose tolerance tests and the clamp technique were performed pre- and post-IIT. Remission was defined as maintenance of target glycaemic control without anti-diabetic agents for 1 year. Results The remission rate was 50% (5/10). There were no differences in the acute insulin response or glucose infusion rate between groups. The acute glucagon response (AGR) in the remission group pre-IIT was significantly higher than that in the non-remission group (mean 163.02 pg/mL/min vs. mean 16.29 pg/mL/min). The mean AGR post-IIT was lower in the remission group than that in the non-remission group (0 pg/mL/min vs. 19.91 pg/mL/min). Spearman analysis indicated that the AGR pre-IIT and the change in the AGR were correlated with remission (r = 0.731). Conclusion The insulin-mediated glucose disposal rate was significantly improved with the normalization of blood glucose levels following transient IIT. Subjects with a higher AGR pre-IIT and a greater AGR decrease post-IIT displayed a greater likelihood of long-term remission.

scholarly journals Long Term Evaluation of Intensive Insulin Therapy in Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 2 (3) ◽  
pp. 88-94
Author(s):  
Leilani B Mercado-Asis ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Intensive Insulin Therapy ◽  
Demographic Data

Background: This study aimed to determine long-term effect of intensive insulin therapy on prevention, progression, and development of chronic diabetes complications, both micro and macrovascular events. This study also aimed to evaluate long-term sustainability of glycemic control of patients on intensive insulin treatment. Methods: A retrospective review of adult type 2 diabetes mellitus (T2DM) patients on intensive insulin therapy for ≥7 years. Demographic data, co-morbidities, body mass index (BMI), hemoglobin A1c (HbA1c), hospitalization were collated. Majority received intensive insulin therapy with combination of premixed 70/30 given two times a day and fast short acting analogue given premeal three times a day, with the addition of glargine or degludec once a day in some. Results: Among 76 patients, 62% were males and 38% were females. Mean age at diagnosis and last visit were 53 and 65 years, respectively. At time of diagnosis, patient had the following co-morbidities: hypertension (32%), dyslipidemia (13%), non-dialyzable chronic kidney disease (CKD) (4%), thyroid disease (1%), pulmonary tuberculosis (1%). In terms of long-term complications, event rates during follow up period are as follows: 0.001 per person-year for acute coronary event; 0.002 per person-year for CKD needing dialysis, 0.009 per person-year for cerebrovascular accident. There were no blindness and amputation observed. There is a statistical difference between HbA1c levels at time of diagnosis (8.53 ± 1.86) and last follow up (7.83 ± 1.71) (P = 0.00). After a median follow up of 12 years (7–22 years), glycemic control was sustained with an HbA1c of ≤7% and ≤8% in 32% and 45% of patients, respectively. Conclusion: With intensive insulin therapy, micro and macrovascular complications can be prevented significantly. Long-term sustainability of glycemic control was also achieved.

scholarly journals Long-Term Intensive Insulin Therapy for Japanese Patients with Type 2 Diabetes Mellitus

2008 ◽  
Vol 47 (24) ◽  
pp. 2109-2115 ◽  
Author(s):  
Tomoya Umezono ◽  
Masao Toyoda ◽  
Makiko Abe ◽  
Keiko Kobayashi ◽  
Mayuko Kato ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Intensive Insulin Therapy ◽  
Japanese Patients
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