PMID- 25364873
OWN - NLM
STAT- MEDLINE
DCOM- 20160923
LR  - 20221207
IS  - 1936-2692 (Electronic)
IS  - 1088-0224 (Linking)
VI  - 20
IP  - 9
DP  - 2014 Sep 1
TI  - Long-term glycemic control after 6 months of basal insulin therapy.
PG  - e369-79
AB  - OBJECTIVES: To compare the effects of a 6-month course of insulin therapy versus 
      oral antidiabetic drugs (OADs) on long-term (5-year) glycemic control in patients 
      newly diagnosed with type 2 diabetes mellitus (T2DM) with severe hyperglycemia. 
      STUDY DESIGN: 5 years' follow-up of a randomized controlled trial. METHODS: Newly 
      diagnosed patients with T2DM and severe hyperglycemia were hospitalized and 
      treated with intensive insulin injections for 10 to 14 days. Fifty patients were 
      randomized to receive either insulin injections or OADs for an additional 6 
      months. Subjects were followed for 5 years to evaluate long-term glycemic 
      control. We compared the glycated hemoglobin (A1C) levels of the treatment groups 
      and the proportion of patients in each group who reached the treatment targets. 
      We also examined the remission rate (A1C </=6.5% without antidiabetic medication) 
      at the end of the 5 years. The mechanisms of improved glycemic control and 
      possible mechanism of remission were also investigated. RESULTS: At 5 years, A1C 
      levels remained lower in the insulin group than in the OAD group (6.49 +/- 0.72% vs 
      7.72 +/- 1.06%; P = .012). The proportion of subjects with A1C levels </=6.5% was 
      significantly higher in the insulin group than in the OAD group (63.6% vs 23.5%; 
      P = .013). The remission rate was 27.3% in the insulin group and 5.9% in the OAD 
      group (P = .048). CONCLUSIONS: This randomized trial demonstrated that a 6-month 
      course of insulin therapy led to better 5-year glycemic control, reflected by 
      lower A1C levels, than did oral antidiabetic agent therapy. Moreover, the 
      insulin-treated group had a significantly higher rate of remission from diabetes.
FAU - Chen, Harn-Shen
AU  - Chen HS
AD  - Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans 
      General Hospital, Taipei, Taiwan. E-mail: chenhs@vghtpe.gov.tw.
FAU - Wu, Tzu-En
AU  - Wu TE
FAU - Kuo, Chin-Sung
AU  - Kuo CS
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20140901
PL  - United States
TA  - Am J Manag Care
JT  - The American journal of managed care
JID - 9613960
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (hemoglobin A1c protein, human)
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Hyperglycemia/prevention & control
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Insulin/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Remission Induction
EDAT- 2014/11/05 06:00
MHDA- 2016/09/24 06:00
CRDT- 2014/11/04 06:00
PHST- 2014/11/04 06:00 [entrez]
PHST- 2014/11/05 06:00 [pubmed]
PHST- 2016/09/24 06:00 [medline]
AID - 85726 [pii]
PST - epublish
SO  - Am J Manag Care. 2014 Sep 1;20(9):e369-79.