Long-term Efficacy of Nateglinide after Short-term Insulin Treatment to Remove Glucose Toxicity in Poorly Controlled Type 2 Diabetes

Abstract

We studied the long-term efficacy of nateglinide after short-term insulin treatment to remove glucose toxicity in 41 patients with poorly controlled (HbA_1c>10%) type 2 diabetes.We regarded a successful outcome as maintenance of HbAic at<6.5% for over 6 months.Outcome was successful in 33 (HbA_1c4.6-6.4%) but unsuccessful in 8 (HbA_1c6.9-10.7%).No significant difference was seen in age, gender, body mass index, fasting serum C-peptide, units of insulin at exchange, or period of insulin use between groups. Disease duration from diagnosis and the period of use of sulphonylurea (SU) agents, however, were significantly longer in unsuccessful control (5.0±4.1 vs 2.0±3.0 years;p<0.03, 1.6±1.1 vs 0.4±0.9 years;p=0.003).These factors were therefore considered important in determining a change from insulin treatment to oral hypoglycemic agents.Although SU agents are conventionally used in such a change, we suggest that nateglinide is the drug of choice due to its pharmacological characteristics in type 2 diabetes of short duration.