Abstract
Objective: The current consensus algorithm for management of type 2 diabetes is based on the fasting glucose concentration and glycated haemoglobin A1c (HbA1c) level. We applied a new therapeutic strategy by assessing insulin secretion and insulin resistance, in addition to glucose concentrations in individual patients. Design and patients: We enrolled 193 patients with type 2 diabetes. The patients were assigned to one of six groups according to insulin secretion measured by the serum fasting C-peptide concentration and insulin resistance measured by an insulin tolerance test (ITT). The two groups were treated differently: 108 patients were treated using a new staged diabetes management (SDM) strategy and 85 patients continued with conventional therapy. Measurements: We compared metabolic variables in the two groups at baseline and 12 months after enrolment. Results: In patients treated with the SDM strategy, fasting glucose concentration decreased from 9.8 ± 2.1 to 8.2 ± 1.7 mmol/l (P < 0.001). Postprandial 2-h glucose concentration decreased from 14.19 ± 3.34 to 12.27 ± 3.24 mmol/l (P < 0.001). HbA1c level decreased from 8.37 ± 1.42% to 7.72 ± 1.39% (P < 0.001). About 43% of the new SDM group achieved an HbA1c of < 7.0% compared with 25% of patients in the conventional treatment group. Conclusions: The new SDM strategy, based on individual data on insulin resistance and insulin secretion, may provide valuable clinical benefits in non-obese Korean patients with type 2 diabetes.
| Original language | English |
|---|---|
| Pages (from-to) | 549-555 |
| Number of pages | 7 |
| Journal | Clinical Endocrinology |
| Volume | 69 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2008 Oct 1 |
Fingerprint
All Science Journal Classification (ASJC) codes
- Endocrinology, Diabetes and Metabolism
- Endocrinology
Cite this
}
Staged diabetes management according to individual patient insulin resistance and β-cell function ameliorates glycaemic control in type 2 diabetes mellitus. / Choi, Sung Hee; Hur, Kyu Yeon; Kim, Dae Jung; Ahn, Chul Woo; Kang, Eun Seok; Cha, Bong Soo; Lim, Sungkil; Huh, Kap Bum; Lee, Hyun Chul.
In: Clinical Endocrinology, Vol. 69, No. 4, 01.10.2008, p. 549-555.Research output: Contribution to journal › Article
TY - JOUR
T1 - Staged diabetes management according to individual patient insulin resistance and β-cell function ameliorates glycaemic control in type 2 diabetes mellitus
AU - Choi, Sung Hee
AU - Hur, Kyu Yeon
AU - Kim, Dae Jung
AU - Ahn, Chul Woo
AU - Kang, Eun Seok
AU - Cha, Bong Soo
AU - Lim, Sungkil
AU - Huh, Kap Bum
AU - Lee, Hyun Chul
PY - 2008/10/1
Y1 - 2008/10/1
N2 - Objective: The current consensus algorithm for management of type 2 diabetes is based on the fasting glucose concentration and glycated haemoglobin A1c (HbA1c) level. We applied a new therapeutic strategy by assessing insulin secretion and insulin resistance, in addition to glucose concentrations in individual patients. Design and patients: We enrolled 193 patients with type 2 diabetes. The patients were assigned to one of six groups according to insulin secretion measured by the serum fasting C-peptide concentration and insulin resistance measured by an insulin tolerance test (ITT). The two groups were treated differently: 108 patients were treated using a new staged diabetes management (SDM) strategy and 85 patients continued with conventional therapy. Measurements: We compared metabolic variables in the two groups at baseline and 12 months after enrolment. Results: In patients treated with the SDM strategy, fasting glucose concentration decreased from 9.8 ± 2.1 to 8.2 ± 1.7 mmol/l (P < 0.001). Postprandial 2-h glucose concentration decreased from 14.19 ± 3.34 to 12.27 ± 3.24 mmol/l (P < 0.001). HbA1c level decreased from 8.37 ± 1.42% to 7.72 ± 1.39% (P < 0.001). About 43% of the new SDM group achieved an HbA1c of < 7.0% compared with 25% of patients in the conventional treatment group. Conclusions: The new SDM strategy, based on individual data on insulin resistance and insulin secretion, may provide valuable clinical benefits in non-obese Korean patients with type 2 diabetes.
AB - Objective: The current consensus algorithm for management of type 2 diabetes is based on the fasting glucose concentration and glycated haemoglobin A1c (HbA1c) level. We applied a new therapeutic strategy by assessing insulin secretion and insulin resistance, in addition to glucose concentrations in individual patients. Design and patients: We enrolled 193 patients with type 2 diabetes. The patients were assigned to one of six groups according to insulin secretion measured by the serum fasting C-peptide concentration and insulin resistance measured by an insulin tolerance test (ITT). The two groups were treated differently: 108 patients were treated using a new staged diabetes management (SDM) strategy and 85 patients continued with conventional therapy. Measurements: We compared metabolic variables in the two groups at baseline and 12 months after enrolment. Results: In patients treated with the SDM strategy, fasting glucose concentration decreased from 9.8 ± 2.1 to 8.2 ± 1.7 mmol/l (P < 0.001). Postprandial 2-h glucose concentration decreased from 14.19 ± 3.34 to 12.27 ± 3.24 mmol/l (P < 0.001). HbA1c level decreased from 8.37 ± 1.42% to 7.72 ± 1.39% (P < 0.001). About 43% of the new SDM group achieved an HbA1c of < 7.0% compared with 25% of patients in the conventional treatment group. Conclusions: The new SDM strategy, based on individual data on insulin resistance and insulin secretion, may provide valuable clinical benefits in non-obese Korean patients with type 2 diabetes.
UR - http://www.scopus.com/inward/record.url?scp=51649105628&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=51649105628&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2265.2008.03199.x
DO - 10.1111/j.1365-2265.2008.03199.x
M3 - Article
VL - 69
SP - 549
EP - 555
JO - Clinical Endocrinology
JF - Clinical Endocrinology
SN - 0300-0664
IS - 4
ER -