Induction of long‐term normoglycemia without medication in Korean type 2 diabetes patients after continuous subcutaneous insulin infusion therapy

Park, Sunmin; Choi, Soo Bong

doi:10.1002/dmrr.343

Cited by 54 publications

(37 citation statements)

References 30 publications

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“…To our knowledge, there has been no report of the effects of combination therapies of insulin and mitiglinide or nateglinide in patients with type 2 diabetes mellitus. In daily clinical practice we sometimes experience that type 2 diabetic patients can maintain good glycemic control with or without sulfonylurea after short-term intensive insulin therapy but even these reports are very few [20,21]. The results of our study indicated the effectiveness of short-term combination therapy of mitiglinide and insulin glargine.…”

Section: Discussionmentioning

confidence: 55%

Therapeutic Efficacy of Mitiglinide Combined with Once Daily Insulin Glargine after Switching from Multiple Daily Insulin Regimen of Aspart Insulin and Glargine in Patients with Type 2 Diabetes Mellitus

et al. 2006

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Abstract. Mitiglinide is novel class of rapid-acting insulin secretagogues, which have been widely used alone or in combination with other oral hypoglycemic drugs to improve postprandial hyperglycemia in early type 2 diabetes. While mitiglinide enhances postprandial requirement of insulin, the efficacy of mitiglinide combined with insulin has yet to be established. We investigated the efficacy of mitiglinide combined with insulin glargine, the first soluble insulin analog that has a flat and prolonged effect. After control with the intensive regimen (daily aspart insulin and glargine), 30 inpatients with type 2 diabetes were switched to premeal mitiglinide combined with once daily insulin glargine (mitiglinide regimen), and daily profiles of blood glucose level were compared under each regimen. Fifteen patients showed similar control of hyperglycemia with mitiglinide regimen and intensive insulin regimen, assessed by M value (<32), while the remaining 15 showed worsening under the mitiglinide regimen. The patients who were well controlled with mitiglinide regimen were significantly younger (51.9 ± 16.0 years, p<0.005) and heavier (body mass index: 25.7 ± 3.3 kg/m 2 , p<0.05) than those who were not (67.9 ± 8.7 and 23.0 ± 3.1, respectively). Moreover, insulin doses of aspart per body weight were significantly fewer in effective group than in ineffective group. Duration of diabetes was shorter in the effective group, albeit insignificantly. Previous treatment before starting intensive insulin regimen, such as insulin and sulfonylurea, was not different between the two groups. Our results suggest that mitiglinide plus insulin glargine combination therapy is useful for lowering both fasting and postprandial hyperglycemia in a subpopulation of type 2 diabetes. The long-term effects of such treatment need to be established in future studies.

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Section: Discussionmentioning

confidence: 55%

Therapeutic Efficacy of Mitiglinide Combined with Once Daily Insulin Glargine after Switching from Multiple Daily Insulin Regimen of Aspart Insulin and Glargine in Patients with Type 2 Diabetes Mellitus

et al. 2006

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“…120 They also had better initial glycaemic control, shorter duration of diabetes, with fewer diabetic complications and earlier attainment of glycaemic targets following initiation of IIT. 121,122 These factors suggest that individuals with relatively preserved beta-cell function at treatment onset respond better to IIT.…”

Section: Reviewmentioning

confidence: 99%

Targeting beta-cell preservation in the management of type 2 diabetes

2017

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Type 2 diabetes (T2D) is widely considered a chronic and progressive disease without cure. As beta-cell function progressively declines over time, blood glucose rises. Current management of T2D involves incremental introduction of dietary and drug therapies to achieve normoglycaemia. However, recent studies have demonstrated remission of T2D following bariatric surgery, very low calorie diet or intensive insulin therapy, raising the possibility that the declining beta-cell function in T2D may be arrested or even reversed. The point at which such interventions are introduced in the course of T2D is key for clinical benefit. Future treatment strategies should be revised to target early betacell preservation and thus disease remission. This article reviews the pathogenesis of beta-cell dysfunction and evidence for the clinical benefit of preserving beta-cell function in T2D, and discusses the evidence for beta-cell preservation of current glucose-lowering therapies with particular reference to their effect when initiated at the time of diagnosis of T2D. Br J Diabetes 2017;17:134-144

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“…[35][36][37][38][39][40] A study using continuous subcutaneous insulin infusion (CSII) as intensive therapy over 2 weeks led to long-term glycemic control, improvement in bcell function, and restoration of first-phase insulin response, with many individuals achieving remission. 36 Similarly, in a study by Ryan et al, 39 intensive insulin therapy using …”

Section: Clinical Evidence For Earlier Initiation Of Insulinmentioning

confidence: 99%

Clinical Evidence for the Earlier Initiation of Insulin Therapy in Type 2 Diabetes

Owens

2013

Diabetes Technology & Therapeutics

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The natural history of type 2 diabetes mellitus (T2DM) is a relentless progression of b-cell failure and dysregulation of b-cell function with increasing metabolic derangement. Insulin remains the only glucose-lowering therapy that is efficacious throughout this continuum. However, the timing of introduction and the choice of insulin therapy remain contentious because of the heterogeneity of T2DM and the well-recognized behavioral and therapeutic challenges associated with this mode of therapy. Nevertheless, the early initiation of basal insulin has been shown to improve glycemic control and affect long-term outcomes in people with T2DM and is a treatment strategy supported by international guidelines as part of an individualized approach to chronic disease management. The rationale for early initiation of insulin is based on evidence demonstrating multifaceted benefits, including overcoming the glucotoxic effects of hyperglycemia, thereby facilitating ''bcell rest,'' and preserving b-cell mass and function, while also improving insulin sensitivity. Independent of its effects on glycemic control, insulin possesses anti-inflammatory and antioxidant properties that may help protect against endothelial dysfunction and damage resulting in vascular disease. Insulin therapy and the achievement of good glycemic control earlier in T2DM provide long-term protection to end organs via ''metabolic memory'' regardless of subsequent treatments and degree of glycemic control. This is evidenced from long-term observations continuing from trials such as the United Kingdom Prospective Diabetes Study. As such, early initiation of insulin therapy may not only help to avoid the effects of prolonged glycemic burden, but may also positively alter the course of disease progression.

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Induction of long‐term normoglycemia without medication in Korean type 2 diabetes patients after continuous subcutaneous insulin infusion therapy

Cited by 54 publications

References 30 publications

Therapeutic Efficacy of Mitiglinide Combined with Once Daily Insulin Glargine after Switching from Multiple Daily Insulin Regimen of Aspart Insulin and Glargine in Patients with Type 2 Diabetes Mellitus

Therapeutic Efficacy of Mitiglinide Combined with Once Daily Insulin Glargine after Switching from Multiple Daily Insulin Regimen of Aspart Insulin and Glargine in Patients with Type 2 Diabetes Mellitus

Targeting beta-cell preservation in the management of type 2 diabetes

Clinical Evidence for the Earlier Initiation of Insulin Therapy in Type 2 Diabetes

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