An Analysis of Patients With Severe Type 2 Diabetes Improved to Normal Glucose Tolerance or Impaired Glucose Tolerance After Hospitalized Intensive Therapy

Abstract

A study was performed on patients with severe type 2 diabetes, including those with diabetic ketoacidosis (mean HbA1c of 13 %), whose glucose tolerance improved to normal or impaired status after short-term intensive insulin therapy. The clinical history and laboratory values were analyzed using medical records for 24 patients who achieved good glycemic control with oral hypoglycemic agents without insulin or a GLP-1 agonist after the intensive therapy and underwent a 75-g oral glucose tolerance test after receiving the therapy. Five patients showed normal glucose tolerance, 13 had impaired glucose tolerance, and 6 had a persistent diabetes pattern. Compared with the diabetic group, patients with normal or impaired glucose tolerance were more frequently newly diagnosed with diabetes and had a higher HOMA-β (86.0 [63.6] vs. 59.6 [25.2], p=0.02) after treatment. These results suggest that intensive insulin therapy is effective for the recovery of the beta cell function and improvement of glucose tolerance in patients with severe diabetes, including diabetic ketoacidosis, to a condition of normal or impaired tolerance.