Early Effects of Short-term Intensive Insulin Therapy and Long-term Comparison of Newly Diagnosed and Previously Treated Type 2 Diabetic Patients

Abstract

We investigated the early effects of short-term intensive insulin therapy (STIIT) in 174 type 2 diabetic patients with HbA1c level 8.4 % and above. We also compared the long-term effects of voglibose and metformin after STIIT in 74 newly diagnosed patients and 64 previously treated patients. STIIT significantly decreased the levels of blood glucose and high-sensitivity C-reactive protein and the HOMA-IR scores and increased the HOMA-β scores. The HbA1c levels were correlated with the blood glucose levels and inversely correlated with the HOMA-β scores and duration of diabetes before STIIT; however, three months after treatment, the HbA1c levels were directly correlated with the duration of diabetes, reflecting the basic β-cell function under the subsidence of glucose toxicity. The newly diagnosed patients exhibited significantly stronger improvements than the previously treated patients (HbA1c level less than 6.9 %: 66 % vs. 30 %) . The patients with a shorter duration of diabetes demonstrated better responses to STIIT than those with a longer duration of diabetes. A multiple logistic regression analysis adjusted for age and gender showed that both factors independently contributed to the improvements. Among the previously treated patients, some patients exhibited difficulties during treatment, while others demonstrated β-cell preservation. Early relief from glucose toxicity due to STIIT offers substantial benefits to patients with poorly controlled type 2 diabetes.