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

Y. H. Lee, byungwan lee, S. W. Chun, B. S. Cha, H. C. Lee

Research output: Contribution to journalArticle

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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 bsubesub, 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 (â 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.

Original languageEnglish
Pages (from-to)1076-1084
Number of pages9
JournalInternational Journal of Clinical Practice
Volume65
Issue number10
DOIs
Publication statusPublished - 2011 Oct 1

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Insulin
glimepiride
Biphasic Insulins
Type 2 Diabetes Mellitus
Fasting
Obesity
Glucose
Therapeutics
glycosylated serum albumin

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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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-na{\"i}ve, 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 bsubesub, 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 ({\^a} 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.",
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Predictive characteristics of patients achieving glycaemic control with insulin after sulfonylurea failure. / Lee, Y. H.; lee, byungwan; Chun, S. W.; Cha, B. S.; Lee, H. C.

In: International Journal of Clinical Practice, Vol. 65, No. 10, 01.10.2011, p. 1076-1084.

Research output: Contribution to journalArticle

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N2 - 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 bsubesub, 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 (â 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.

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