Fasting plasma glucose after intensive insulin therapy predicted long-term glycemic control in newly diagnosed type 2 diabetic patients

Short‐term intensive insulin therapy could be the preferred option for new onset Type 2 diabetes mellitus patients with HbA1c > 9%

“…It would be worthwhile to precisely identify the subpopulation more likely to benefit from this strategy. Previous studies have suggested that lower baseline fasting glucose, higher BMI, better early phase insulin secretion, and lower exogenous insulin requirements may be predictors of diabetes remission in newly diagnosed patients treated with STII therapy . A recent study demonstrated that a shorter duration of diabetes supplanted baseline HbA1c and β‐cell function as an independent predictor of remission .…”

“…Lower baseline fasting glucose Higher BMI Better early phase insulin secretion Lower exogenous insulin requirements, shorter duration of diabetes 8,9,[21][22][23]30 Opposite to listed pros Acceptability Significant improvement in patient-reported QoL and treatment satisfaction after early insulin therapy 11 Reluctance to initiate insulin treatment in T2DM…”

“…Previous studies have suggested that lower baseline fasting glucose, higher BMI, better early phase insulin secretion, and lower exogenous insulin requirements may be predictors of diabetes remission in newly diagnosed patients treated with STII therapy. 8,9,17,21,22 A recent study demonstrated that a shorter duration of diabetes supplanted baseline HbA1c and β-cell function as an independent predictor of remission. 23 In particular, diabetes duration <2 years predicted sustained remission, suggesting that the key determinant of inducing persistent drug-free diabetes remission with STII is early intervention.…”

Short‐term intensive insulin therapy at diagnosis in type 2 diabetes: plan for filling the gaps

“…Mechanistically, it is possible that, once STII therapy is implemented, alleviation of the glucotoxic effect on the existing beta‐cell mass gives these patients more capacity to improve endogenous insulin secretion. With respect to specific biological markers, studies have indicated that improved beta‐cell response and remission of hyperglycaemia can be predicted by increased 1,5‐Anhydroglucitol [a validated short‐term marker of glycaemic control] , preserved late‐phase insulin secretion , fasting plasma glucose measured after cessation of treatment , and higher HbA 1c .…”

Practical application of short-term intensive insulin therapy based on the concept of “treat to target” to reduce hypoglycaemia in routine clinical site

“…Indeed, it is possible that stepwise addition of insulin leads to the reduction of hyperglucagonaemia.The evidence of this treatment has been presented to prove benefits in the treatment of T2DM. However, in most SIIT studies, after SIIT they did not use any anti-diabetic agents and evaluated the duration of glycaemic remission [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] . As the results, glycaemic remission was temporary, especially when beta-cell function was markedly deteriorated after SIIT.…”