Location of Repository

Prospective randomized study for optimal insulin therapy in type 2 diabetic patients with secondary failure

By Tojo Katsuyoshi, Yokota Kuninobu, Yokota Tamotsu, Kurata Hideaki, Matsudaira Toru, Nemoto Masami, Nishimura Rimei, Miyashita Yumi, Utsunomiya Kazunori and Tajima Naoko

Abstract

<p>Abstract</p> <p>Background</p> <p>The large clinical trials proved that Basal-Bolus (BB) insulin therapy was effective in the prevention of diabetic complications and their progression. However, BB therapy needs multiple insulin injections per a day. In this regard, a biphasic insulin analogue needs only twice-daily injections, and is able to correct postprandial hyperglycemia. Therefore it may achieve the blood glucose control as same as that of BB therapy and prevent the diabetic complications including macroangiopathy.</p> <p>Methods</p> <p>In PROBE (Prospective, Randomized, Open, Blinded-Endpoint) design, forty-two type 2 diabetic patients (male: 73.8%, median(inter quartile range) age: 64.5(56.8~71.0)years) with secondary failure of sulfonylurea (SU) were randomly assigned to BB therapy with a thrice-daily insulin aspart and once-daily basal insulin (BB group) or to conventional therapy with a twice-daily biphasic insulin analogue (30 Mix group), and were followed up for 6 months to compare changes in HbA1c, daily glycemic profile, intima-media thickness (IMT) of carotid artery, adiponectin levels, amounts of insulin used, and QOL between the two groups.</p> <p>Results</p> <p>After 6 months, HbA1c was significantly reduced in both groups compared to baseline (30 Mix; 9.3(8.1~11.3) → 7.4(6.9~8.7)%, p < 0.01, vs BB;8.9(7.7~10.0) → 6.9(6.2~7.3)%, p < 0.01), with no significant difference between the groups in percentage change in HbA1c (30 Mix; -14.7(-32.5~-7.5)% vs BB -17.8(-30.1~-11.1)%, p = 0.32). There was a significant decrease in daily glycemic profile at all points except dinner time in both groups compared to baseline. There was a significant increase in the amount of insulin used in the 30 Mix group after treatment compared to baseline (30 Mix;0.30(0.17~0.44) → 0.39(0.31~0.42) IU/kg, p = 0.01). There was no significant difference in IMT, BMI, QOL or adiponectin levels in either group compared to baseline.</p> <p>Conclusion</p> <p>Both BB and 30 mix group produced comparable reductions in HbA1c in type 2 diabetic patients with secondary failure. There was no significant change in IMT as an indicator of early atherosclerotic changes between the two groups. The basal-bolus insulin therapy may not be necessarily needed if the type 2 diabetic patients have become secondary failure.</p> <p>Trial registration</p> <p>Current Controlled Trials number, NCT00348231</p

Topics: Diseases of the circulatory (Cardiovascular) system, RC666-701, Specialties of internal medicine, RC581-951, Internal medicine, RC31-1245, Medicine, R, DOAJ:Cardiovascular, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: BioMed Central
Year: 2008
DOI identifier: 10.1186/1475-2840-7-16
OAI identifier: oai:doaj.org/article:03427f69aea84484b143c9b48ec21f09
Journal:
Download PDF:
Sorry, we are unable to provide the full text but you may find it at the following location(s):
  • https://doaj.org/toc/1475-2840 (external link)
  • http://www.cardiab.com/content... (external link)
  • https://doaj.org/article/03427... (external link)
  • Suggested articles


    To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.