Staged diabetes management according to individual patient insulin resistance and β-cell function ameliorates glycaemic control in type 2 diabetes mellitus

Sung Hee Choi, Kyu Yeon Hur, Dae Jung Kim, Chul Woo Ahn, Eun Seok Kang, Bong Soo Cha, Sung Kil Lim, Kap Bum Huh, Hyun Chul Lee

Research output: Contribution to journalArticle

5 Citations (Scopus)

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 languageEnglish
Pages (from-to)549-555
Number of pages7
JournalClinical Endocrinology
Volume69
Issue number4
DOIs
Publication statusPublished - 2008 Oct

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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