OBJECTIVE -To investigate whether long-term optimal glycemic control can be achieved without medication by transient continuous subcutaneous insulin infusion (CSII) and the possible mechanisms responsible for this remission.RESEARCH DESIGN AND METHODS -Newly diagnosed type 2 diabetic patients (n ϭ 138, fasting glucose Ͼ11.1mmol/l) were hospitalized and treated with CSII for 2 weeks. Intravenous glucose tolerance tests (IVGTTs) were performed, and blood glucose, HbA 1c , lipid profiles, proinsulin, insulin, and C-peptide were measured before and after CSII. Patients were followed longitudinally on diet alone after withdrawal of insulin.RESULTS -Optimal glycemic control was achieved within 6.3 Ϯ 3.9 days by CSII in 126 patients. The remission rates (percentages maintaining near euglycemia) at the third, sixth, twelfth, and twenty-fourth month were 72.6, 67.0, 47.1, and 42.3%, respectively. Patients who maintained glycemic control Ͼ12 months (remission group) had greater recovery of ␤-cell function than those who did not (nonremission group) when assessed immediately after CSII. Homeostasis model assessment of ␤-cell function (HOMA-B) and the area under the curve (AUC) of insulin during IVGTT were higher in the remission group (145.4 Ϯ 89.6 vs. 78.5 Ϯ 68.5, P ϭ 0.002, and 1,423.4 Ϯ 523.2 vs. 1,159.5 Ϯ 476.8 pmol ⅐ l Ϫ1 ⅐ min Ϫ1 , P ϭ 0.044). Change in acute insulin response was also greater in the remission group than that in the nonremission group (621.8 Ϯ 430.4 vs. 387.3 Ϯ 428.8 pmol ⅐ l Ϫ1 ⅐ min Ϫ1 , P ϭ 0.033).CONCLUSIONS -Short-term intensive insulin therapy can induce long-term glycemic control in newly diagnosed type 2 diabetic patients with severe hyperglycemia. The improvement of ␤-cell function, especially the restoration of first-phase insulin secretion, could be responsible for the remission. Diabetes Care 27:2597-2602, 2004␤ -Cell dysfunction and decreased insulin sensitivity are the main pathophysiological defects responsible for the development of hyperglycemia (1). With continuous presence of insulin resistance, progressive loss of ␤-cell function is the crucial defect. The continuous decline in ␤-cell function is affected by glucotoxicity generated by hyperglycemia and lipotoxicity due to lipolysis (2). The vicious cycle of elevated glucose further impairs and possibly destroys ␤-cells, finally stopping insulin production completely (3). Therefore, optimal metabolic control, especially early intensive glycemic control, plays a role in the prevention of progressive ␤-cell dysfunction and worsening of diabetes. Many reports have shown (4 -6) that induction of normoglycemia in type 2 diabetes resulted in both improved ␤-cell function and insulin resistance. Ryan, Imes, and Wallace (7) recently reported that, in severe newly diagnosed type 2 diabetic patients, a 2-to 3-weeks' course of intensive insulin therapy by multiple daily insulin injection could successfully lay a foundation for prolonged good glycemic control. So the potential benefits of early, aggressive intervention with insulin treatment to...

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In the literature of cooperative (co-op) advertising, the focus of the research is on a relationship in which a manufacturer is the leader and retailers are followers. This relationship implies the dominance of the manufacturer over retailers. Recent market trends have shown a shift in power from manufacturers to retailers. Retailers, as aresult, may now possess equal or even greater power than a manufacturer in some instances when it comes to retailing. Based on this new market phenomenon, we intend to explore the role of co-op advertising in a manufacturer-retailer supply chain through brand name investments, local advertising expenditures, and sharing rules of advertising expenses. Two co-op advertising models are developed and compared. The first co-op advertising model is based on the traditional leader-follower relationship of a manufacturer and a retailer. The second model incorporates partnership into co-op advertising coordination. Business examples and managerial implications of the models have been discussed. A cooperative bargaining technique is utilized to implement the partnership co-op advertising model.

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Supplementary data are available at Bioinformatics online.

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