Abstract
We studied predictive factors in maintenance therapy for type 2 diabetic patients with poor glycemic control (HbA1c≥10%) and no treatment history. We classified 146 patients who maintained glycemic control of HbA1c<7.0% after 2-week in-hospital training in glycemic control into three groups: Group A: 84 undergoing diet therapy alone; Group B: 23 administered drugs that do not easily cause hypoglycemia, such as biguanides, α-glucosidase inhibitor, and thiazolidinedione; and Group C: 39 administered drugs that can induce hypoglycemic risk, such as sulphonylureas and insulin. In Group A, 41 maintained HbA1c<5.5% by diet therapy alone. No significant difference was seen in age, fasting plasma glucose, HbA1c, body mass index, or urinary excretion of C peptide during hospitalization among the three groups, and these were not regarded as predictive factors in maintenance therapy. The ratio of patients with diabetic retinopathy at hospitalization was high in Group C. The interval until HbA1c<7.0% was achieved was shorter in Group A than in Group C, and body weight loss until HbA1c<7.0% was achieved was greater in Group A than in Group C. No significant difference was seen in the interval until HbA1c<7.0% was achieved in the presence of retinopathy in Group C. The presence of diabetic retinopathy at initial diagnosis was a predictive factor in maintenance therapy in our study.
