title: Insulin requirement profiles of short-term intensive insulin therapy in patients with newly diagnosed type 2 diabetes and its association with long-term glycemic remission.
abstract: OBJECTIVE
  To investigate the insulin requirement profiles during short-term intensive continuous subcutaneous insulin infusion (CSII) in patients with newly diagnosed type 2 diabetes and its relationship with long-term glycemic remission.
  
  
  METHODS
  CSII was applied in 104 patients with newly diagnosed type 2 diabetes. Daily insulin doses were titrated and recorded to achieve and maintain euglycemia for 2 weeks. Measurements of blood glucose, lipid profiles as well as intravenous glucose tolerance tests were performed before and after the therapy. Afterwards, patients were followed up for 1 year.
  
  
  RESULTS
  Total daily insulin dose (TDD) was 56.6±16.1IU at the first day when euglycemia was achieved (TDD-1). Thereafter, TDD progressively decreased at a rate of 1.4±1.0IU/day to 36.2±16.5IU at the end of the therapy. TDD-1 could be estimated with body weight, FPG, triglyceride and waist circumference in a multiple linear regression model. Decrement of TDD after euglycemia was achieved (ΔTDD) was associated with reduction of HOMA-IR (r=0.27, P=0.008) but not with improvement in β cell function. Patients in the lower tertile of ΔTDD had a significantly higher risk of hyperglycemia relapse than those in the upper tertile within 1 year (HR 3.4, 95%CI [1.4, 8.4], P=0.008).
  
  
  CONCLUSIONS
  There is a steady decline of TDD after euglycemia is achieved in patients with newly diagnosed type 2 diabetes treated with CSII, and ΔTDD is associated with a better long-term glycemic outcome.
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan er Road, Guangzhou 510080, China.
authors.forename: Liehua
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan er Road, Guangzhou 510080, China.
authors.forename: Weijian
authors.initials: W
authors.lastname: Ke
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan er Road, Guangzhou 510080, China.
authors.forename: Xuesi
authors.initials: X
authors.lastname: Wan
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan er Road, Guangzhou 510080, China.
authors.forename: Pengyuan
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan er Road, Guangzhou 510080, China.
authors.forename: Xiaopei
authors.initials: X
authors.lastname: Cao
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan er Road, Guangzhou 510080, China.
authors.forename: Wanping
authors.initials: W
authors.lastname: Deng
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, Zhongshan er Road, Guangzhou 510080, China. Electronic address: lyb2047@163.com.
authors.forename: Yanbing
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012074:Remission Induction
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008055:Lipids
keywords: Insulin requirement; Intensive insulin therapy; Newly diagnosed type 2 diabetes; Remission