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

Endocrine Journal

Wenjun Sun²  Zhaoling Wang³  Weiyun Qian⁴  Libin Zhou¹  Qin Gong⁵  Hao Hu²  Dong Wang²  Qichao Yang²  Shuqin Yu²  Caoming Mao²  Guoyue Yuan²  Su Wang²  Dezhi Chen³ 

[1] Ruijin Hospital, Center of Molecular Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Jiaotong University Medical School, Shanghai, China;Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China;Department of Endocrinology, the First people’s Hospital of Xuzhou, Xuzhou, China;Department of Endocrinology, the Third Affiliated Hospital of Suchow University, Changzhou, China;Department of Endocrinology, the First people’s Hospital of Suqian, Suqian, China

关键词: β-cell function;    Glycemic variability;    Continuous subcutaneous insulin infusion;    Sitagliptin;    Type 2 diabetes;   

DOI  :  10.1507/endocrj.EJ15-0160

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(49)Cited-By(1)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.

【 授权许可】

Unknown