Intensive Conventional Insulin Therapy for Type II Diabetes: Metabolic effects during a 6-mo outpatient trial

Henry, Robert R.; Gumbiner, Barry M.; Ditzler, Timothy M.; Wallace, Penny; Lyon, Rachel; Glauber, Harry

doi:10.2337/diacare.16.1.21

Cited by 222 publications

(148 citation statements)

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“…The relationship between insulin dose and BWt gain is well described [2,3], but that with HbA 1 c is more tenuous. For example, Henry et al [30] found no correlation between the two, while Sinha et al [5] found a negative correlation with FFM alone. This has significant therapeutic implications.…”

Section: Discussionmentioning

confidence: 99%

Use of a reference four-component model to define the effects of insulin treatment on body composition in type 2 diabetes: the ?Darwin study?

et al. 2005

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Aims: To define the effects of insulin treatment on body composition and fat distribution, and investigate the potential role of body weight (BWt) gain predictors in patients with poorly controlled type 2 diabetes. , with the FFM increase due solely to total body water [TBW; +2.4 (1.5) l], as there were no detectable changes in total body protein or bone mineral, thereby increasing FFM hydration by 1.3%. More body fat was deposited centrally in patients receiving insulin alone than those receiving insulin with an oral hypoglycaemic agent (metformin). Daily insulin dose, HbA 1 c and hip circumference were independent predictors of BWt gain. Conclusions: Insulin treatment increased fat and FFM similarly in poorly controlled type 2 diabetes patients, with the FFM gain due entirely to TBW. The possible role of metformin in reducing central fat accumulation following insulin treatment warrants further investigation into its mechanism and potential long-term benefits.

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Section: Discussionmentioning

confidence: 99%

Use of a reference four-component model to define the effects of insulin treatment on body composition in type 2 diabetes: the ?Darwin study?

et al. 2005

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“…This seems doubtful since near euglycemia can almost always be achieved if enough insulin is given appropriately to cooperative patients (11,12). (These subjects are likely to be cooperative since they volunteered for a clinical trial.)…”

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confidence: 99%

Starting Insulin Therapy in Type 2 Diabetic Patients

Davidson

2005

Diabetes Care

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“…Oral tedavi ile glisemik kontrol sağlanamayan hastalarda, oral tedaviye bazal insülin (NPH, detemir, glargin) eklenebilir (McCulloch ve Nathan, 2010). Birlikte kullanılan metformin total insü-lin ihtiyacında azalma sağlar (Henry, 1993 Gereksinim duyulan bazal insülin dozu 0,3-0,4 Ü/kg/gün kadardır. Ancak 10 U şeklinde de başlanır, üç günlük ortalama sabah açlık kan şekeri >130 mg/dl ise, üç günde bir insülin dozu 2-4 Ü olarak artırılır ve hedef açlık glisemisi elde edilir (Nathan ve ark., 2006).…”

Section: Tip 2 Diyabette Insülin Tedavi şEmalarıunclassified

Tip 2 diabetes mellitusta insülin tedavisi

Atmaca¹

2012

jecm

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İnsülin, tip 2 diyabetteki hiperglisemi tedavisinde mevcut tedaviler içerisinde en etkili olanıdır. Uygun şekilde kullanıldığında, artmış HbA1C'yi arzulanan hedefe düşürebilir. Tüm tip 1 diyabetiklere insulin tedavisi gerekli iken, tip 2 diyabetiklerde insulin tedavisinin nasıl olacağı veya ne zaman başlanacağı konusu o kadar açık değildir. Belirgin kilo kaybı, ciddi hiperglisemi veya ketosis durumlarında insulin hemen başlanmalıdır. Bu durumların dışında, insulin dışındaki tedavilerle veya bir veya daha fazla non-insülin ajanlarla glisemik hedeflere ulaşılamıyorsa insülin tedavisi eklenmelidir. Glukoz kontrolü sağlandıktan ve semptomlar düzeldikten sonra insulin tedavisi kesilebilir veya devam edilebilir. Burada kısaca tip 2 diyabette insulin tedavisi gözden geçirilecektir.J. Exp. Clin. Med., 2012;29:S44-S48 ABSTRACTInsulin is the most effective available medication for treating hyperglycemia in type 2 diabetes. If appropriately used, it can decrease any level of elevated HbA1C to, or close to, the desired goal. Whereas insulin therapy is required in all patients with type 1 diabetes, the decision of how and when to start insulin in type 2 diabetes is not as straightforward. Insulin usually should be started immediately in patients with marked weight loss, severe hyperglycemia, or ketosis. In the absence of these features, insulin should be added when glycemic goals are not met with one or more non-insulin agents, or when glycemic goals are unlikely to be achieved with non-insulin therapy. After the glucose is controlled and symptoms are relieved, it may be possible to withdraw the insulin or to be continued. Here, insulin therapy in patients with type 2 diabetes will be briefly reviewed.

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Intensive Conventional Insulin Therapy for Type II Diabetes: Metabolic effects during a 6-mo outpatient trial

Cited by 222 publications

References 0 publications

Use of a reference four-component model to define the effects of insulin treatment on body composition in type 2 diabetes: the ?Darwin study?

Use of a reference four-component model to define the effects of insulin treatment on body composition in type 2 diabetes: the ?Darwin study?

Starting Insulin Therapy in Type 2 Diabetic Patients

Tip 2 diabetes mellitusta insülin tedavisi

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