PMID- 23551748
OWN - NLM
STAT- MEDLINE
DCOM- 20140310
LR  - 20130805
IS  - 1753-0407 (Electronic)
IS  - 1753-0407 (Linking)
VI  - 5
IP  - 3
DP  - 2013 Sep
TI  - Current role of short-term intensive insulin strategies in newly diagnosed type 2 
      diabetes.
PG  - 268-74
LID - 10.1111/1753-0407.12054 [doi]
AB  - Type 2 diabetes mellitus (T2DM) is a progressive disease characterized by 
      worsening insulin resistance and a decline in beta-cell function. Achieving good 
      glycemic control becomes more challenging as beta-cell function continues to 
      deteriorate throughout the disease process. The traditional management paradigm 
      emphasizes a stepwise approach, and insulin has generally been reserved as a 
      final armament. However, mounting evidence indicates that short-term intensive 
      insulin therapy used in the early stages of type 2 diabetes could improve beta-cell 
      function, resulting in better glucose control and more extended glycemic 
      remission than oral antidiabetic agents. Improvements in insulin sensitivity and 
      lipid profile were also seen after the early initiation of short-term intensive 
      insulin therapy. Thus, administering short-term intensive insulin therapy to 
      patients with newly diagnosed T2DM has the potential to delay the natural process 
      of this disease, and should be considered when clinicians initiate treatment. 
      Although the early use of insulin is advocated by some guidelines, the optimal 
      time to initiate insulin therapy is not clearly defined or easily recognized, and 
      a pragmatic approach is lacking. Herein we summarize the current understanding of 
      early intensive insulin therapy in patients with newly diagnosed T2DM, focusing 
      on its clinical benefit and problems, as well as possible biological mechanisms 
      of action, and discuss our perspective.
CI  - (c) 2013 Wiley Publishing Asia Pty Ltd and Ruijin Hospital, Shanghai Jiaotong 
      University School of Medicine.
FAU - Xu, Wen
AU  - Xu W
AD  - Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-sen 
      University, Guangzhou, China.
FAU - Weng, Jianping
AU  - Weng J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20130529
PL  - Australia
TA  - J Diabetes
JT  - Journal of diabetes
JID - 101504326
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Blood Glucose/metabolism
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy/physiopathology
MH  - Humans
MH  - Hypoglycemic Agents/administration & dosage/therapeutic use
MH  - Insulin/administration & dosage/*therapeutic use
MH  - *Insulin Resistance
MH  - Insulin-Secreting Cells/drug effects/metabolism
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - glycemic remission
OT  - insulin therapy
OT  - type 2 diabetes
OT  - beta-cell function
OT  - 血糖缓解，胰岛素治疗，2型糖尿病，beta细胞功能
EDAT- 2013/04/05 06:00
MHDA- 2014/03/13 06:00
CRDT- 2013/04/05 06:00
PHST- 2012/03/18 00:00 [received]
PHST- 2013/02/26 00:00 [revised]
PHST- 2013/03/27 00:00 [accepted]
PHST- 2013/04/05 06:00 [entrez]
PHST- 2013/04/05 06:00 [pubmed]
PHST- 2014/03/13 06:00 [medline]
AID - 10.1111/1753-0407.12054 [doi]
PST - ppublish
SO  - J Diabetes. 2013 Sep;5(3):268-74. doi: 10.1111/1753-0407.12054. Epub 2013 May 29.