Insulin Requirement Profiles of Patients with Type 2 Diabetes After Achieving Stabilized Glycemic Control with Short-Term Continuous Subcutaneous Insulin Infusion

Noh, Yun Hee; Lee, Won Jin; Kim, Kyoung Ah; Lim, Inja; Lee, Jun Ho; Lee, Ju Han; Kim, Seonguk; Choi, Soo Bong

doi:10.1089/dia.2009.0131

Cited by 14 publications

(13 citation statements)

References 25 publications

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“…17 In all, the mean total daily insulin dose was 31.66 -9.85 IU (i.e., 0.48 -0.19 IU/ kg/day) for our 171 patients. As research on the Indian population shows, the daily insulin dose of 46 T2DM patients was 44.0 -23.7 U/day 18 (i.e., 0.61 IU/kg/day), when treatment was transitioned from MDI to CSII for 6 months, and the insulin dose was higher than that of our patients.…”

Section: Discussionmentioning

confidence: 77%

Investigation of the Insulin Dose and Characteristics of Continuous Subcutaneous Insulin Infusion in Chinese People with Type 2 Diabetes

Gao

Dong²,

Li³

et al. 2011

Diabetes Technology & Therapeutics

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Section: Discussionmentioning

confidence: 77%

Investigation of the Insulin Dose and Characteristics of Continuous Subcutaneous Insulin Infusion in Chinese People with Type 2 Diabetes

Gao

Dong²,

Li³

et al. 2011

Diabetes Technology & Therapeutics

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“…In our previous study, we observed that insulin deficiency given physiological needs is common in patients with T2DM receiving oral antidiabetic agents or insulin injections when they need to restrict calorie to achieve euglycemia and that they do not require calorie restriction to achieve euglycemia when insulin requirements are corrected for physiological needs by continuous subcutaneous insulin infusion therapy. 15 However, few patients with T2DM use continuous subcutaneous insulin infusion therapy, and therefore they require calorie restriction in addition to medical treatment to achieve euglycemia.…”

Section: Introductionmentioning

confidence: 99%

Diet control to achieve euglycemia induces significant loss of heart and liver weight via increased autophagy compared with ad libitum diet in diabetic rats

Lee

Jin

et al. 2014

Exp Mol Med

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Intensive glucose control increases the all-cause mortality in type 2 diabetes mellitus (T2DM); however, the underlying mechanisms remain unclear. We hypothesized that strict diet control to achieve euglycemia in diabetes damages major organs, increasing the mortality risk. To evaluate effects on major organs when euglycemia is obtained by diet control, we generated a model of end-stage T2DM in 13-week-old Sprague-Dawley rats by subtotal pancreatectomy, followed by ad libitum feeding for 5 weeks. We divided these rats into two groups and for the subsequent 6 weeks provided ad libitum feeding to half (AL, n=12) and a calorie-controlled diet to the other half (R, n=12). To avoid hypoglycemia, the degree of calorie restriction in the R group was isocaloric (g per kg body weight per day) compared with a sham-operated control group (C, n=12). During the 6-week diet control period, AL rats ate three times more than rats in the C or R groups, developing hyperglycemia with renal hyperplasia. R group achieved euglycemia but lost overall body weight significantly compared with the C or AL group (49 or 22%, respectively), heart weight (39 or 23%, respectively) and liver weight (50 or 46%, respectively). Autophagy levels in the heart and liver were the highest in the R group (P<0.01), which also had the lowest pAkt/Akt levels among the groups (P<0.05 in the heart; P<0.01 in the liver). In conclusion, glycemic control achieved by diet control can prevent hyperglycemia-induced renal hyperplasia in diabetes but may be deleterious even at isocaloric rate when insulin is deficient because of significant loss of heart and liver mass via increased autophagy.

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“…Several previous studies support positively our findings on the basal dose proportion. A study by Noh et al [27] showed that the daily basal dose was 36 ± 12% of the TDD in Korean hospitalized subjects with type 2 diabetes after achieving normoglycemia with CSII. With regard to the Japanese subjects with type 1 diabetes, the daily basal dose during hospitalization was 27.7% of TDD in those treated with CSII therapy [28], and the basal insulin requirement was 37.3% of TDD in those adequately controlled (HbA1c ≤7.9%) with CSII therapy [29].…”

Section: Discussionmentioning

confidence: 99%

Insulin requirement profiles in Japanese hospitalized subjects with type 2 diabetes treated with basal-bolus insulin therapy

et al. 2015

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To assess the total daily inulin dose (TDD) and contribution of basal insulin to TDD and to identify the predictive factors for insulin requirement profiles in subjects with type 2 diabetes, we retrospectively examined insulin requirement profiles of 275 hospitalized subjects treated with basal-bolus insulin therapy (BBT) (mean age, 60.1 ± 12.9 years; HbA1c, 10.2 ± 4.5%). Target plasma glucose level was set between 80 and 129 mg/dL before breakfast and between 80 and 179 mg/dL at 2-hour after each meal without causing hypoglycemia. We also analyzed the relationship between the insulin requirement profiles (TDD and basal/total daily insulin ratio [B/TD ratio]) and insulin-associated clinical parameters. The mean TDD was 0.463 ± 0.190 unit/kg/day (range, 0.16-1.13 unit/kg/day). The mean B/TD ratio was 0.300 ± 0.099 (range, 0.091-0.667). A positive correlation of TDD with B/TD ratio was revealed by linear regression analysis (r=0.129, p=0.03). Stepwise multiple regression analysis identified post-breakfast glucose levels before titrating insulin as an independent determinant of the insulin requirement profile [Std β (standard regression coefficient) = 0.228, p<0.01 for TDD, Std β = -0.189, p<0.01 for B/TD ratio]. The TDD was <0.6 unit/kg/day and the B/TD ratio was <0.4 in the majority (70.2%) of subjects in the present study. These findings may have relevance in improving glycemic control and decreasing the risk of hypoglycemia and weight gain in subjects with type 2 diabetes treated with BBT.

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Insulin Requirement Profiles of Patients with Type 2 Diabetes After Achieving Stabilized Glycemic Control with Short-Term Continuous Subcutaneous Insulin Infusion

Cited by 14 publications

References 25 publications

Investigation of the Insulin Dose and Characteristics of Continuous Subcutaneous Insulin Infusion in Chinese People with Type 2 Diabetes

Investigation of the Insulin Dose and Characteristics of Continuous Subcutaneous Insulin Infusion in Chinese People with Type 2 Diabetes

Diet control to achieve euglycemia induces significant loss of heart and liver weight via increased autophagy compared with ad libitum diet in diabetic rats

Insulin requirement profiles in Japanese hospitalized subjects with type 2 diabetes treated with basal-bolus insulin therapy

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