Characteristics predictive for a successful switch from insulin analogue therapy to oral hypoglycemic agents in patients with type 2 diabetes

Gyuri Kim, Yong Ho Lee, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee, Byung Wan Lee

Research output: Contribution to journalArticle

Abstract

Purpose: The objective of this study was to investigate clinical and laboratory parameters that could predict which patients could maintain adequate glycemic control after switching from initial insulin therapy to oral hypoglycemic agents (OHAs) among patients with type 2 diabetes (T2D). Materials and Methods: We recruited 275 patients with T2D who had been registered in 3 cohorts of initiated insulin therapy and followed up for 33 months. The participants were divided into 2 groups according to whether they switched from insulin to OHAs (Group I) or not (Group II), and Group I was further classified into 2 sub-groups: maintenance on OHAs (Group IA) or resumption of insulin (Group IB). Results: Of 275 patients with insulin initiation, 63% switched to OHAs (Group I) and 37% continued insulin (Group II). Of these, 44% were in Group IA and 19% in Group IB. The lowest tertile of baseline postprandial C-peptide-to-glucose ratio (PCGR), higher insulin dose at switching to OHAs, and higher HbA1c level at 6 months after switching to OHAs were all associated with OHA failure (Group IB; p=0.001, 0.046, and 0.014, respectively). The lowest tertile of PCGR was associated with ultimate use of insulin (Group IB and Group II; p=0.029). Conclusion: Higher baseline level of PCGR and lower HbA1c levels at 6 months after switching to OHAs may be strong predictors for the successful maintenance of OHAs after switching from insulin therapy in Korean patients with T2D.

Original languageEnglish
Pages (from-to)1395-1403
Number of pages9
JournalYonsei medical journal
Volume57
Issue number6
DOIs
Publication statusPublished - 2016 Nov

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Hypoglycemic Agents
Type 2 Diabetes Mellitus
Insulin
C-Peptide
Therapeutics
Glucose
Maintenance

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Kim, Gyuri ; Lee, Yong Ho ; Kang, Eun Seok ; Cha, Bong Soo ; Lee, Hyun Chul ; Lee, Byung Wan. / Characteristics predictive for a successful switch from insulin analogue therapy to oral hypoglycemic agents in patients with type 2 diabetes. In: Yonsei medical journal. 2016 ; Vol. 57, No. 6. pp. 1395-1403.
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abstract = "Purpose: The objective of this study was to investigate clinical and laboratory parameters that could predict which patients could maintain adequate glycemic control after switching from initial insulin therapy to oral hypoglycemic agents (OHAs) among patients with type 2 diabetes (T2D). Materials and Methods: We recruited 275 patients with T2D who had been registered in 3 cohorts of initiated insulin therapy and followed up for 33 months. The participants were divided into 2 groups according to whether they switched from insulin to OHAs (Group I) or not (Group II), and Group I was further classified into 2 sub-groups: maintenance on OHAs (Group IA) or resumption of insulin (Group IB). Results: Of 275 patients with insulin initiation, 63{\%} switched to OHAs (Group I) and 37{\%} continued insulin (Group II). Of these, 44{\%} were in Group IA and 19{\%} in Group IB. The lowest tertile of baseline postprandial C-peptide-to-glucose ratio (PCGR), higher insulin dose at switching to OHAs, and higher HbA1c level at 6 months after switching to OHAs were all associated with OHA failure (Group IB; p=0.001, 0.046, and 0.014, respectively). The lowest tertile of PCGR was associated with ultimate use of insulin (Group IB and Group II; p=0.029). Conclusion: Higher baseline level of PCGR and lower HbA1c levels at 6 months after switching to OHAs may be strong predictors for the successful maintenance of OHAs after switching from insulin therapy in Korean patients with T2D.",
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Characteristics predictive for a successful switch from insulin analogue therapy to oral hypoglycemic agents in patients with type 2 diabetes. / Kim, Gyuri; Lee, Yong Ho; Kang, Eun Seok; Cha, Bong Soo; Lee, Hyun Chul; Lee, Byung Wan.

In: Yonsei medical journal, Vol. 57, No. 6, 11.2016, p. 1395-1403.

Research output: Contribution to journalArticle

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AU - Lee, Yong Ho

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AU - Lee, Hyun Chul

AU - Lee, Byung Wan

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AB - Purpose: The objective of this study was to investigate clinical and laboratory parameters that could predict which patients could maintain adequate glycemic control after switching from initial insulin therapy to oral hypoglycemic agents (OHAs) among patients with type 2 diabetes (T2D). Materials and Methods: We recruited 275 patients with T2D who had been registered in 3 cohorts of initiated insulin therapy and followed up for 33 months. The participants were divided into 2 groups according to whether they switched from insulin to OHAs (Group I) or not (Group II), and Group I was further classified into 2 sub-groups: maintenance on OHAs (Group IA) or resumption of insulin (Group IB). Results: Of 275 patients with insulin initiation, 63% switched to OHAs (Group I) and 37% continued insulin (Group II). Of these, 44% were in Group IA and 19% in Group IB. The lowest tertile of baseline postprandial C-peptide-to-glucose ratio (PCGR), higher insulin dose at switching to OHAs, and higher HbA1c level at 6 months after switching to OHAs were all associated with OHA failure (Group IB; p=0.001, 0.046, and 0.014, respectively). The lowest tertile of PCGR was associated with ultimate use of insulin (Group IB and Group II; p=0.029). Conclusion: Higher baseline level of PCGR and lower HbA1c levels at 6 months after switching to OHAs may be strong predictors for the successful maintenance of OHAs after switching from insulin therapy in Korean patients with T2D.

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