Short Course of Insulin Treatment versus Metformin in Newly Diagnosed Patients with Type 2 Diabetes

Journal of Clinical Medicine
Marta SeghieriEle Ferrannini

Abstract

The ß-cell dysfunction of type 2 diabetes is partly reversible. The optimal time window to induce glycemic remission is uncertain; short courses of insulin treatment have been tested as a strategy to induce remission. In a pilot study in 38 newly-diagnosed patients, we assessed the time-course of insulin sensitivity and ß-cell function (by repeat oral glucose tolerance tests) following a 6-week basal insulin treatment compared to metformin monotherapy in equipoised glycemic control. At 6 weeks, insulin secretion and sensitivity were increased in both groups whilst ß-cell glucose sensitivity was unchanged. From this time onwards, in the insulin group glycemia started to rise at 3 months, and was no longer different from baseline at 1 year. The initial improvement in insulin secretion and sensitivity dissipated. In the metformin group, fasting plasma glucose and HbA1c levels reached a nadir at 8 months, at which time insulin secretion, glucose and insulin sensitivity were significantly better than at baseline and higher than in the insulin group. A short course of basal insulin in newly-diagnosed patients does not appear to offer clinical advantage over recommended initiation with metformin.

References

Oct 18, 2008·Diabetes, Obesity & Metabolism·A Mari, E Ferrannini
Dec 31, 2009·Diabetes Care·Jonathan B BrownGregory A Nichols
May 7, 2010·Cell Metabolism·Ele Ferrannini
Jul 23, 2011·The Journal of Clinical Endocrinology and Metabolism·M NannipieriE Ferrannini
May 15, 2013·The Journal of Clinical Endocrinology and Metabolism·Brenno AstiarragaEle Ferrannini
Mar 14, 2014·The Lancet. Diabetes & Endocrinology·Caroline Kaercher KramerRavi Retnakaran

❮ Previous
Next ❯

Citations

Oct 20, 2020·Experimental Physiology·Carina PreviateClaudinéia Conationi da Silva Franco
Jul 3, 2021·International Journal of Molecular Sciences·Isabella PanfoliDavide Maggi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Biomarkers for Type 2 Diabetes

Biomarkers can help understand chronic diseases and assist in risk prediction for prevention and early detection of diseases. Here is the latest research on biomarkers in type 2 diabetes, a disease in which the body is unable to produce or properly use insulin.