Predictive characteristics of patients achieving glycaemic control with insulin after sulfonylurea failure
- Authors
- Lee, Y. -H.; Lee, B. -W.; Chun, S. W.; Cha, B. S.; Lee, H. C.
- Issue Date
- Oct-2011
- Publisher
- Medicom International, Inc.
- Citation
- International Journal of Clinical Practice, v.65, no.10, pp 1076 - 1084
- Pages
- 9
- Journal Title
- International Journal of Clinical Practice
- Volume
- 65
- Number
- 10
- Start Page
- 1076
- End Page
- 1084
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/16185
- DOI
- 10.1111/j.1742-1241.2011.02755.x
- ISSN
- 1368-5031
1742-1241
- Abstract
- Aim: We investigated the clinical and metabolic parameters in type 2 diabetic patients who were inadequately controlled on sulfonylurea (SU) before initiating insulin therapy to characterise patients who are likely to achieve target glycaemic control with insulin analogues. Methods: A total of 120 Korean patients aged >= 40 years with insulin-naive, poorly controlled, SU-treated type 2 diabetes were randomised on the basis of SU dose, and obesity with 1 : 1 ratio of insulin detemir (long-acting analogue; LAA) and 70% insulin aspart protamine and 30% insulin aspart (biphasic insulin analogue; BIA). Patients who failed to reach <= 20% glycated albumin (GA) at 3 weeks were switched to therapy with a twice-daily BIA for 16 weeks. Results: Mean HbA(1c), GA, fasting and stimulated plasma glucose levels were significantly reduced after 16 weeks compared with the baseline in all groups, and 40% of patients reached the target HbA(1c) (<= 7%). Compared with responders, non-responders had significantly longer duration of diabetes and higher dose of glimepiride. However, there was no significant difference in insulin secretory profiles between responders and non-responders. Clinical factors such as diabetes duration, SU dose and BMI were independently associated with inadequate response to insulin analogues in patients with secondary failure. Conclusions: In type 2 diabetics with secondary SU failure, clinical parameters such as duration of diabetes (< 10 years), SU dose (<= 4 mg) and BMI should be taken into consideration as important factors than laboratory indices related to beta-cell function when predicting the response to insulin analogues.
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