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

Authors
 이병완 ; 이현철 ; 차봉수 
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
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/94085
DOI
10.1111/j.1742-1241.2011.02755.x
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
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Link
 http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2011.02755.x/abstract
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