3 627

Cited 19 times in

Predictive characteristics of patients achieving glycaemic control with insulin after sulfonylurea failure

Authors
 Y.-H. Lee  ;  B.-W. Lee  ;  S. W. Chun  ;  B. S. Cha  ;  H. C. Lee 
Citation
 INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Vol.65(10) : 1076-1084, 2011 
Journal Title
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
ISSN
 1368-5031 
Issue Date
2011
MeSH
Administration, Oral ; Aged ; Blood Glucose/metabolism* ; Body Mass Index ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy* ; Diabetes Mellitus, Type 2/physiopathology ; Female ; Glycated Hemoglobin A/metabolism ; Humans ; Hypoglycemic Agents/therapeutic use* ; Insulin/analogs & derivatives* ; Insulin-Secreting Cells/physiology ; Male ; Middle Aged ; Obesity/complications ; Prospective Studies ; SulfonylureaCompounds/therapeutic use* ; TreatmentFailure
Abstract
AIM: We investigated the clinical and metabolic parameters in type 2 diabetic patients who were inadequately controlled on sulfonylurea (SU) before initiating insulin therapy to characterise patients who are likely to achieve target glycaemic control with insulin analogues.

METHODS: A total of 120 Korean patients aged ≥ 40 years with insulin-naïve, poorly controlled, SU-treated type 2 diabetes were randomised on the basis of SU dose, and obesity with 1 : 1 ratio of insulin detemir (long-acting analogue; LAA) and 70% insulin aspart protamine and 30% insulin aspart (biphasic insulin analogue; BIA). Patients who failed to reach ≤ 20% glycated albumin (GA) at 3 weeks were switched to therapy with a twice-daily BIA for 16 weeks.

RESULTS: Mean HbA(1c) , GA, fasting and stimulated plasma glucose levels were significantly reduced after 16 weeks compared with the baseline in all groups, and 40% of patients reached the target HbA(1c) ( ≤ 7%). Compared with responders, non-responders had significantly longer duration of diabetes and higher dose of glimepiride. However, there was no significant difference in insulin secretory profiles between responders and non-responders. Clinical factors such as diabetes duration, SU dose and BMI were independently associated with inadequate response to insulin analogues in patients with secondary failure.

CONCLUSIONS: In type 2 diabetics with secondary SU failure, clinical parameters such as duration of diabetes (< 10 years), SU dose ( ≤ 4 mg) and BMI should be taken into consideration as important factors than laboratory indices related to β-cell function when predicting the response to insulin analogues.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2011.02755.x/abstract
DOI
10.1111/j.1742-1241.2011.02755.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Hyun Chul(이현철)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94085
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links