Journal of Clinical Medicine
Effects of Intensive Insulin Therapy Within One Week on Glycemic Control and β-Cell Function in Patients with T2DM
By Wei Jiang, Xubin Yang, Beisi Lin and 8 others.
Abstract
Objective
To evaluate the impact of intensive insulin therapy (IIT) within 1 week on glycemic control and β-cell function indices in patients with type 2 diabetes mellitus (T2DM).
Methods
This retrospective study included 726 patients with T2DM who underwent continuous subcutaneous insulin infusion within 1 week. Patients were divided into three groups based on disease duration: short (≤1 year), medium (>1 and <10 years), and long (≥10 years) duration groups. The primary outcome was the changes in glycemic control and β-cell function indices after IIT. Factors influencing the improvement in β-cell function metrics were also analyzed.
Results
After IIT within 1 week, fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels significantly decreased (p < 0.01 for both). HOMA-β, 30 min insulinogenic index, 30 min disposition index, and insulin secretion sensitivity index-2 markedly improved from baseline [37.69 (41.03) VS. 32.40 (46.06), 3.16 (3.97) VS. 2.12 (3.51), 336.85 (397.05) VS. 188.93 (263.45), and 185.92 (122.89) VS. 120.81 (90.12), respectively] (p < 0.01 for all). Insulin sensitivity, measured by HOMA-IR and Matsuda index, significantly improved (p < 0.01 for both). Significantly greater improvements in glycemic control and β-cell function measures were observed in patients with a shorter diabetes duration. Age, duration of diabetes, BMI, HbA1c, duration of IIT, and time in range were significantly associated with improvements in β-cell function indices.