title: 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.
abstract: Glycemic variability (GV) has been proposed as contributor to diabetes-related macrovascular complications. This randomized control trial evaluated a new combination therapy with continuous subcutaneous insulin infusion (CSII) plus sitagliptin (CSII + sitagliptin) vs. CSII only in terms of metabolic control, GV and β-cell function in patients with newly diagnosed type 2 diabetes (T2DM). 217 patients were randomized to two weeks of CSII (n = 108) or CSII + sitagliptin (n = 109) therapy. As a measure of GV, the coefficient of variation (CV) was computed from capillary blood glucose during the first and second week, respectively. β-cell function before and after treatment was determined with the Insulin Secretion-Sensitivity Index-2 (ISSI-2). Good metabolic controls were established with both therapies. CSII + sitagliptin therapy resulted in greater improvements in CV and ISSI-2 than CSII alone (all P = 0.000). For each group, change in CV was inversely correlated with change in ISSI-2 (r = -0.529, P = 0.000 and r = -0.433, P = 0.000, respectively). The multivariate regression analysis demonstrated that improved ISSI-2 was the only independent contributor to reduced CV in both groups (standardized β = -0.388, P = 0.004 and standardized β = -0.472, P = 0.000, respectively). Correction of β-cell function in newly diagnosed T2DM patients via use of either CSII or CSII + sitagliptin therapy was feasible in controlling GV to prevent secondary complications of T2DM. Moreover, CSII + sitagliptin therapy was superior to CSII monotherapy in terms of GV.
authors.affiliation: Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
authors.forename: Guoyue
authors.initials: G
authors.lastname: Yuan
authors.forename: Hao
authors.initials: H
authors.lastname: Hu
authors.forename: Su
authors.initials: S
authors.lastname: Wang
authors.forename: Qichao
authors.initials: Q
authors.lastname: Yang
authors.forename: Shuqin
authors.initials: S
authors.lastname: Yu
authors.forename: Wenjun
authors.initials: W
authors.lastname: Sun
authors.forename: Weiyun
authors.initials: W
authors.lastname: Qian
authors.forename: Caoming
authors.initials: C
authors.lastname: Mao
authors.forename: Libin
authors.initials: L
authors.lastname: Zhou
authors.forename: Dezhi
authors.initials: D
authors.lastname: Chen
authors.forename: Zhaoling
authors.initials: Z
authors.lastname: Wang
authors.forename: Qin
authors.initials: Q
authors.lastname: Gong
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
mesh_terms: D000328:Adult; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D050417:Insulin-Secreting Cells / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D000068900:Sitagliptin Phosphate / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D000068900:Sitagliptin Phosphate