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 language | English |
|---|---|
| Pages (from-to) | 1076-1084 |
| Number of pages | 9 |
| Journal | International Journal of Clinical Practice |
| Volume | 65 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2011 Oct 1 |
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Predictive characteristics of patients achieving glycaemic control with insulin after sulfonylurea failure. / Lee, Y. H.; Lee, B. W.; 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 journal › Article
TY - JOUR
T1 - Predictive characteristics of patients achieving glycaemic control with insulin after sulfonylurea failure
AU - Lee, Y. H.
AU - Lee, B. W.
AU - Chun, S. W.
AU - Cha, B. S.
AU - Lee, H. C.
PY - 2011/10/1
Y1 - 2011/10/1
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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=80053022273&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80053022273&partnerID=8YFLogxK
U2 - 10.1111/j.1742-1241.2011.02755.x
DO - 10.1111/j.1742-1241.2011.02755.x
M3 - Article
C2 - 21923847
AN - SCOPUS:80053022273
VL - 65
SP - 1076
EP - 1084
JO - International Journal of Clinical Practice
JF - International Journal of Clinical Practice
SN - 1368-5031
IS - 10
ER -