Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment
BackgroundThere were a limited number of studies about β-cell function after insulin initiation in patients exposed to long durations of sulfonylurea treatment. In this study, we aimed to evaluate the recovery of β-cell function and the efficacy of concurrent sulfonylurea use after the start of long...
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| Format: | Article |
| Language: | English |
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Korean Diabetes Association
2016-10-01
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| Series: | Diabetes & Metabolism Journal |
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| Online Access: | https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-40-454.pdf |
| _version_ | 1818207234512912384 |
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| author | Yeoree Yang Jeong-Ah Shin Hae Kyung Yang Seung-Hwan Lee Seung-Hyun Ko Yu-Bae Ahn Kun-Ho Yoon Jae-Hyoung Cho |
| author_facet | Yeoree Yang Jeong-Ah Shin Hae Kyung Yang Seung-Hwan Lee Seung-Hyun Ko Yu-Bae Ahn Kun-Ho Yoon Jae-Hyoung Cho |
| author_sort | Yeoree Yang |
| collection | DOAJ |
| description | BackgroundThere were a limited number of studies about β-cell function after insulin initiation in patients exposed to long durations of sulfonylurea treatment. In this study, we aimed to evaluate the recovery of β-cell function and the efficacy of concurrent sulfonylurea use after the start of long-acting insulin.MethodsIn this randomized controlled study, patients with type 2 diabetes mellitus (T2DM), receiving sulfonylurea for at least 2 years with glycosylated hemoglobin (HbA1c) >7%, were randomly assigned to two groups: sulfonylurea maintenance (SM) and sulfonylurea reduction (SR). Following a 75-g oral glucose tolerance test (OGTT), we administered long-acting basal insulin to the two groups. After a 6-month follow-up, we repeated the OGTT.ResultsAmong 69 enrolled patients, 57 completed the study and were analyzed: 31 in the SM and 26 in the SR group. At baseline, there was no significant difference except for the longer duration of diabetes and lower triglycerides in the SR group. After 6 months, the HbA1c was similarly reduced in both groups, but there was little difference in the insulin dose. In addition, insulin secretion during OGTT was significantly increased by 20% to 30% in both groups. A significant weight gain was observed in the SM group only. The insulinogenic index was more significantly improved in the SR group.ConclusionLong-acting basal insulin replacement could improve the glycemic status and restore β-cell function in the T2DM patients undergoing sulfonylurea-based treatment, irrespective of the sulfonylurea dose reduction. The dose reduction of the concurrent sulfonylurea might be beneficial with regard to weight grain. |
| first_indexed | 2024-12-12T04:25:41Z |
| format | Article |
| id | doaj.art-44dad96344db40a7964308ea1b4dd99d |
| institution | Directory Open Access Journal |
| issn | 2233-6079 2233-6087 |
| language | English |
| last_indexed | 2024-12-12T04:25:41Z |
| publishDate | 2016-10-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| spelling | doaj.art-44dad96344db40a7964308ea1b4dd99d2022-12-22T00:38:13ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872016-10-0140645446210.4093/dmj.2016.40.6.454Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based TreatmentYeoree Yang0Jeong-Ah Shin1Hae Kyung Yang2Seung-Hwan Lee3Seung-Hyun Ko4Yu-Bae Ahn5Kun-Ho Yoon6Jae-Hyoung Cho7Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Serim Hospital, Incheon, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.BackgroundThere were a limited number of studies about β-cell function after insulin initiation in patients exposed to long durations of sulfonylurea treatment. In this study, we aimed to evaluate the recovery of β-cell function and the efficacy of concurrent sulfonylurea use after the start of long-acting insulin.MethodsIn this randomized controlled study, patients with type 2 diabetes mellitus (T2DM), receiving sulfonylurea for at least 2 years with glycosylated hemoglobin (HbA1c) >7%, were randomly assigned to two groups: sulfonylurea maintenance (SM) and sulfonylurea reduction (SR). Following a 75-g oral glucose tolerance test (OGTT), we administered long-acting basal insulin to the two groups. After a 6-month follow-up, we repeated the OGTT.ResultsAmong 69 enrolled patients, 57 completed the study and were analyzed: 31 in the SM and 26 in the SR group. At baseline, there was no significant difference except for the longer duration of diabetes and lower triglycerides in the SR group. After 6 months, the HbA1c was similarly reduced in both groups, but there was little difference in the insulin dose. In addition, insulin secretion during OGTT was significantly increased by 20% to 30% in both groups. A significant weight gain was observed in the SM group only. The insulinogenic index was more significantly improved in the SR group.ConclusionLong-acting basal insulin replacement could improve the glycemic status and restore β-cell function in the T2DM patients undergoing sulfonylurea-based treatment, irrespective of the sulfonylurea dose reduction. The dose reduction of the concurrent sulfonylurea might be beneficial with regard to weight grain.https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-40-454.pdfBasal insulinBeta-cellDiabetes mellitus, type 2RecoverySulfonylurea |
| spellingShingle | Yeoree Yang Jeong-Ah Shin Hae Kyung Yang Seung-Hwan Lee Seung-Hyun Ko Yu-Bae Ahn Kun-Ho Yoon Jae-Hyoung Cho Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment Diabetes & Metabolism Journal Basal insulin Beta-cell Diabetes mellitus, type 2 Recovery Sulfonylurea |
| title | Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment |
| title_full | Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment |
| title_fullStr | Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment |
| title_full_unstemmed | Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment |
| title_short | Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment |
| title_sort | reduction of sulfonylurea with the initiation of basal insulin in patients with inadequately controlled type 2 diabetes mellitus undergoing long term sulfonylurea based treatment |
| topic | Basal insulin Beta-cell Diabetes mellitus, type 2 Recovery Sulfonylurea |
| url | https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-40-454.pdf |
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