Improvement of &amp;beta;-cell function ameliorated glycemic variability in patients with newly diagnosed type 2 diabetes after short-term continuous subcutaneous insulin infusion or in combination with sitagliptin treatment: a randomized control trial

Yuan, Guoyue; Hu, Hao; Wang, Su; Yang, Qing; Yu, Shuqin; Sun, Wenzhao; Qian, Weiyun; Mao, Caoming; Zhou, Libin; Chen, Dezhi; Wang, Zhaoling; Gong, Qingguo; Wang, Dong

doi:10.1507/endocrj.ej15-0160

Cited by 6 publications

(5 citation statements)

References 48 publications

(53 reference statements)

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“…Several studies have assessed the benefits obtained with the combination of CSII and glucose lowering agents in patients with T2D. Combination of sitagliptin with CSII for 2 weeks enabled attainment of similar glycemic targets versus CSII alone, but with lower glycemic variability and improved beta cell function . A study which randomized poorly controlled patients to CSII alone or CSII with the combination of exenatide for 3 days demonstrated increased glycemic variability with exenatide but reduced glucose AUC in an OGTT .…”

Section: What's the Evidence?mentioning

confidence: 99%

The role of insulin pump therapy for type 2 diabetes mellitus

Landau

Wainstein

Bar‐Dayan

2016

Diabetes Metabolism Res

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Many patients with type 2 diabetes fail to achieve adequate glucose control despite escalation of treatment and combinations of multiple therapies including insulin. Patients with long-standing type 2 diabetes often suffer from the combination of severe insulin deficiency in addition to insulin resistance, thereby requiring high doses of insulin delivered in multiple injections to attain adequate glycemic control. Insulin-pump therapy was first introduced in the 1970s as an approach to mimic physiological insulin delivery and attain normal glucose in patients with type 1 diabetes. The recent years have seen an increase in the use of this technology for patients with type 2 diabetes. This article summarizes the clinical studies evaluating insulin pump use in patients with type 2 diabetes and discusses the benefits and shortcomings of pump therapy in this population.

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Section: What's the Evidence?mentioning

confidence: 99%

The role of insulin pump therapy for type 2 diabetes mellitus

Landau

Wainstein

Bar‐Dayan

2016

Diabetes Metabolism Res

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“…Furthermore, protective effects of sitagliptin on beta-cell functions were not noticeable [23]. Other reports, however, indicate some bene ts from intensive insulin therapy with oral anti-hyperglycaemic agents: less hypoglycaemia [10,12,13], lower glycaemic variability [8,14], and less usage of daily insulin [8][9][10][11][12]. For these reasons, adding oral agents to CSII monotherapy may still be useful, even though our monitored end points did not show additional long-term health bene ts.…”

Section: Discussionmentioning

confidence: 99%

Long-term Health Benefits to Newly Diagnosed Type-2 Diabetes from Short-term Continuous-subcutaneous Insulin Injection Therapy

Zhang

et al. 2021

Preprint

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BackgroundContinuous-subcutaneous insulin injection (CSII) therapy to type 2 diabetes mellitus (T2DM) patients generated short-term health benefits. Our aims were to investigate long-term health benefits of CSII monotherapy, in combination with metformin and pioglitazone, or with sitagliptin. MethodsIn this randomized clinical trial, patients were treated for around 90 days and were monitored for one year. Demographic and laboratory data were analysed using the UKPDS_OM2 program to estimate 20-year health benefits. Multiple linear regression model was used to identify factors associated with changes of each health benefit.ResultsFor the 134 treated patients, most health benefit indicators were improved significantly, except for renal failure. For example, life expectancies increased by 0.41±0.48 year and quality-adjusted life expectancy (QALE) by 0.45±0.46 year (p<0.001). Reductions in 20-year risk were: amputation by 70.6%, ulcer 66.7%, blindness 57.1%, stroke 45.5%, myocardial infarction 43.5%, all-causes of death 20.5%, ischaemic heart disease 6.7%, with heart failure < 0.1%. However, no difference in benefits was found among the three therapeutic protocols. Health benefits were lower for older patients, for females in amputation and ulcer risk, and for smokers in blindness risk. ConclusionsShort-term CSII therapy produced significant and multiple long-term health benefits (based on simulated risk analyses) to T2DM patients and benefits were modified by age, sex and smoking factors. The three therapeutic protocols produced the same benefits. Trial registration The clinical trial was registered in ClinicalTrials.gov on November 15, 2011, with the registration number: NCT01471808.

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“…Glucose variability also has been shown to be associated with the activation of oxidative stress and the innate immune system, which increases the risk of diabetic complications [ 18 ]. Previous studies have suggested that add-on sitagliptin therapy is significantly well tolerated and improves HbA1c, fasting blood glucose, and postprandial blood glucose compared with placebo in T2DM [ 19 – 23 ]. One study suggested that sitagliptin added to CSII treatment decreases glucose variability, such as MAGE [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have suggested that add-on sitagliptin therapy is significantly well tolerated and improves HbA1c, fasting blood glucose, and postprandial blood glucose compared with placebo in T2DM [ 19 – 23 ]. One study suggested that sitagliptin added to CSII treatment decreases glucose variability, such as MAGE [ 23 ]. However, in that study, glucose variation was calculated by measuring capillary blood glucose rather than through CGMS; this is a limitation because intermittent glucose monitoring only allows the variation to be estimated.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Continuous Subcutaneous Insulin Infusion and Add-On Therapy with Sitagliptin in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

Wan

Zhao

Shen

et al. 2016

Journal of Diabetes Research

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To identify a new regimen to optimize treatment for patients with newly diagnosed type 2 diabetes (T2DM) by short-term continuous subcutaneous insulin infusion (CSII) alone. Methods. 60 patients with newly diagnosed T2DM were randomized into two groups (n = 30 each) and treated for 2 weeks with CSII alone (CSII group) or with CSII plus sitagliptin (CSII + Sig group). The glycemic variability of the patients was measured using a continuous glucose monitoring system (CGMS) for the last 72 hours. A standard meal test was performed before and after the interventions, and the levels of glycated albumin, fasting glucose, fasting C-peptide, postprandial 2 h blood glucose, and postprandial 2 h C-peptide were examined. Results. Compared with the CSII group, the indicators of glycemic variability, such as the mean amplitude of glycemic excursion (MAGE) and the standard deviation of blood glucose (SDBG), were decreased significantly in the CSII + Sig group. The changes before and after treatment in the C-peptide reactivity index (ΔCPI) and the secretory unit of islet in transplantation index (ΔSUIT) indicated a significant improvement in the CSII + Sig group. Conclusions. Add-on therapy with sitagliptin may be an optimized treatment for patients with newly diagnosed T2DM compared with short-term CSII alone.

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Improvement of β-cell function ameliorated glycemic variability in patients with newly diagnosed type 2 diabetes after short-term continuous subcutaneous insulin infusion or in combination with sitagliptin treatment: a randomized control trial

Cited by 6 publications

References 48 publications

The role of insulin pump therapy for type 2 diabetes mellitus

The role of insulin pump therapy for type 2 diabetes mellitus

Long-term Health Benefits to Newly Diagnosed Type-2 Diabetes from Short-term Continuous-subcutaneous Insulin Injection Therapy

Comparison of the Effects of Continuous Subcutaneous Insulin Infusion and Add-On Therapy with Sitagliptin in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

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