Insulin-based versus triple oral therapy for newly diagnosed type 2 diabetes: which is better?

Abstract:

OBJECTIVE:Early use of insulin after diagnosis of type 2 diabetes is met with resistance because of associated weight gain, hypoglycemia, and fear of decreased compliance and quality of life (QoL). RESEARCH DESIGN AND METHODS:In treatment-naive patients with newly diagnosed type 2 diabetes, insulin and metformin were initiated for a 3-month lead-in period, then patients were randomly assigned to insulin and metformin (insulin group) or metformin, pioglitazone, and glyburide (oral group) for 36 months. Hypoglycemic events, compliance, A1C, weight, QoL, and treatment satisfaction were assessed. RESULTS:Of 29 patients randomly assigned into each group, 83% (insulin group) and 72% (oral group) completed this 3-year study. At study completion, A1C was 6.1 +/- 0.6% (insulin group) versus 6.0 +/- 0.8% (oral group). Weight increased similarly in both groups (P = 0.09) by 4.47 kg (95% CI 0.89-8.04 kg) (insulin group) and 7.15 kg (95% CI 4.18-10.13 kg) (orals group). Hypoglycemic events did not differ between groups (mild 0.51 event/person-month in the insulin group vs. 0.68 event/person-month in the orals group, P = 0.18 and severe 0.04 event/person-year in the insulin group vs. 0.09 event/person-year in the orals group, P = 0.53). Compliance, QoL, and treatment satisfaction were similar between groups, with 100% of patients randomly assigned to insulin willing to continue such treatment. CONCLUSIONS:When compared with a clinically equivalent treatment regimen, insulin-based therapy is effective and did not cause greater weight gain or hypoglycemia nor decrease compliance, treatment satisfaction, or QoL. Insulin is safe, well-accepted, and effective for ongoing treatment of patients with newly diagnosed type 2 diabetes.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Lingvay I,Legendre JL,Kaloyanova PF,Zhang S,Adams-Huet B,Raskin P

doi

10.2337/dc09-0653

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

1789-95

issue

10

eissn

0149-5992

issn

1935-5548

pii

dc09-0653

journal_volume

32

pub_type

杂志文章,随机对照试验
  • The action profile of lispro is not blunted by mixing in the syringe with NPH insulin.

    abstract:OBJECTIVE:To assess the effect of mixing the insulin analog lispro (Humalog) with NPH (Humulin I) before injection on lispro's fast, short action profile. RESEARCH DESIGN AND METHODS:A total of 12 healthy volunteers received subcutaneous abdominal injections of 0.1 U/kg regular insulin and 0.2 U/kg NPH insulin as foll...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.21.12.2098

    authors: Joseph SE,Korzon-Burakowska A,Woodworth JR,Evans M,Hopkins D,Janes JM,Amiel SA

    更新日期:1998-12-01 00:00:00

  • Pancreas transplantation improves vascular disease in patients with type 1 diabetes.

    abstract:OBJECTIVE:Pancreas transplantation (PTX) normalizes glucose and improves microvascular complications, but its impact on macrovascular disease is still debated. RESEARCH DESIGN AND METHODS:Carotid intima-media thickness (IMT), shown to correlate with cardiovascular disease (CVD) risk and events, was determined prospect...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.27.7.1706

    authors: Larsen JL,Colling CW,Ratanasuwan T,Burkman TW,Lynch TG,Erickson JM,Lyden ER,Lane JT,Mack-Shipman LR

    更新日期:2004-07-01 00:00:00

  • Lipid status after pancreas-kidney transplantation.

    abstract:OBJECTIVE:This study was performed to determine the net effects of euglycemia, resolution of renal failure, immunosuppressant drugs, and hyperinsulinemia on fasting lipid profiles of patients with renal failure and insulin-dependent diabetes mellitus (IDDM) after combined pancreas-kidney transplantation (PKT). RESEARC...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.15.1.35

    authors: Larsen JL,Stratta RJ,Ozaki CF,Taylor RJ,Miller SA,Duckworth WC

    更新日期:1992-01-01 00:00:00

  • Receptor binding and effect of biosynthetic human insulin on 2-deoxyglucose transport.

    abstract::Biosynthetic human insulin (BHI) and purified pork insulin (PPI) were compared for binding properties and stimulatory effect on 2-deoxyglucose transport in isolated rat fat cells. No difference between these types of insulin could be demonstrated. ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.4.2.254

    authors: Wieringa T,van Putten JP,Van Dijk-Besling M,Krans HM

    更新日期:1981-03-01 00:00:00

  • Night Shift Work, Genetic Risk, and Type 2 Diabetes in the UK Biobank.

    abstract:OBJECTIVE:To examine the effects of past and current night shift work and genetic type 2 diabetes vulnerability on type 2 diabetes odds. RESEARCH DESIGN AND METHODS:In the UK Biobank, we examined associations of current (N = 272,214) and lifetime (N = 70,480) night shift work exposure with type 2 diabetes risk (6,770 ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc17-1933

    authors: Vetter C,Dashti HS,Lane JM,Anderson SG,Schernhammer ES,Rutter MK,Saxena R,Scheer FAJL

    更新日期:2018-04-01 00:00:00

  • Reduced heart rate variability among youth with type 1 diabetes: the SEARCH CVD study.

    abstract:OBJECTIVE:This study compared heart rate variability (HRV) parameters in youth with and without type 1 diabetes and explored potential contributors of altered HRV. RESEARCH DESIGN AND METHODS:HRV parameters were measured among 354 youth with type 1 diabetes (mean age 18.8 years, diabetes duration 9.8 years, and mean A...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究

    doi:10.2337/dc12-0463

    authors: Jaiswal M,Urbina EM,Wadwa RP,Talton JW,D'Agostino RB Jr,Hamman RF,Fingerlin TE,Daniels S,Marcovina SM,Dolan LM,Dabelea D

    更新日期:2013-01-01 00:00:00

  • The Effect of DPT-1 Intravenous Insulin Infusion and Daily Subcutaneous Insulin on Endogenous Insulin Secretion and Postprandial Glucose Tolerance.

    abstract:OBJECTIVE:To investigate the effect of parenteral insulin therapy on endogenous insulin secretion in the Diabetes Prevention Trial-Type 1 (DPT-1). RESEARCH DESIGN AND METHODS:In the parenteral insulin arm of DPT-1, subjects without diabetes at high risk of future type 1 diabetes randomized to active treatment received...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.2337/dc14-1825

    authors: Hao W,Greenbaum CJ,Krischer JP,Cuthbertson D,Marks JB,Palmer JP

    更新日期:2015-05-01 00:00:00

  • Optimal Blood Pressure Thresholds for Minimal Coronary Artery Disease Risk in Type 1 Diabetes.

    abstract:OBJECTIVE:We aimed to determine optimal blood pressure (BP) thresholds for minimizing coronary artery disease (CAD) risk in people with childhood-onset type 1 diabetes. RESEARCH DESIGN AND METHODS:The Pittsburgh Epidemiology of Diabetes Complications (EDC) Study participants without known CAD at baseline (n = 605) wer...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc19-0480

    authors: Guo J,Brooks MM,Muldoon MF,Naimi AI,Orchard TJ,Costacou T

    更新日期:2019-09-01 00:00:00

  • Is pregnancy in diabetic women associated with folate deficiency?

    abstract:OBJECTIVE:To determine whether folate metabolism in pregnant diabetic women is significantly different from that in pregnant nondiabetic women, thus predisposing them to having offspring with major congenital anomalies. RESEARCH DESIGN AND METHODS:A total of 31 pregnant diabetic women and 54 pregnant nondiabetic contr...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.22.7.1017

    authors: Kaplan JS,Iqbal S,England BG,Zawacki CM,Herman WH

    更新日期:1999-07-01 00:00:00

  • Interaction between plastic catheter tubings and regular insulin preparations used for continuous subcutaneous insulin-infusion therapy.

    abstract::In search of possible interactions between plastic tubings used for insulin-pump treatment and commercial regular insulin preparations, various catheter sets made from polyvinyl chloride (PVC), polyethylene (PE), and nylon plastics were perfused at 30 degrees C in a laboratory setting for up to 72 h. The perfused insu...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.10.3.348

    authors: Chantelau E,Lange G,Gasthaus M,Boxberger M,Berger M

    更新日期:1987-05-01 00:00:00

  • Back to basics in diagnosing diabetic polyneuropathy with the tuning fork!

    abstract:OBJECTIVE:Several national and international scoring systems are used to diagnose diabetic polyneuropathy (PNP). The variety in these scores and the lack of data on validity and predictive value has led to a comparison and validation of the scores with clinical standards for PNP to determine the most powerful measureme...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.28.9.2201

    authors: Meijer JW,Smit AJ,Lefrandt JD,van der Hoeven JH,Hoogenberg K,Links TP

    更新日期:2005-09-01 00:00:00

  • Dietary intake of total, animal, and vegetable protein and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-NL study.

    abstract:OBJECTIVE:Dietary recommendations are focused mainly on relative dietary fat and carbohydrate content in relation to diabetes risk. Meanwhile, high-protein diets may contribute to disturbance of glucose metabolism, but evidence from prospective studies is scarce. We examined the association among dietary total, vegetab...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-1321

    authors: Sluijs I,Beulens JW,van der A DL,Spijkerman AM,Grobbee DE,van der Schouw YT

    更新日期:2010-01-01 00:00:00

  • Incidence of type 2 diabetes using proposed HbA1c diagnostic criteria in the european prospective investigation of cancer-norfolk cohort: implications for preventive strategies.

    abstract:OBJECTIVE:To evaluate the incidence and relative risk of type 2 diabetes defined by the newly proposed HbA(1c) diagnostic criteria in groups categorized by different baseline HbA(1c) levels. RESEARCH DESIGN AND METHODS:Using data from the European Prospective Investigation of Cancer (EPIC)-Norfolk cohort with repeat H...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-2326

    authors: Chamnan P,Simmons RK,Forouhi NG,Luben RN,Khaw KT,Wareham NJ,Griffin SJ

    更新日期:2011-04-01 00:00:00

  • High concentrations of AGE-LDL and oxidized LDL in circulating immune complexes are associated with progression of retinopathy in type 1 diabetes.

    abstract:OBJECTIVE:To determine whether immunocomplexes (ICs) containing advanced glycation end product (AGE)-LDL (AGE-LDL) and oxidized LDL (oxLDL) contribute to the development of retinopathy over a 16-year period in subjects with type 1 diabetes. RESEARCH DESIGN AND METHODS:Levels of AGE-LDL and oxLDL in ICs were measured i...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc11-2040

    authors: Lopes-Virella MF,Baker NL,Hunt KJ,Lyons TJ,Jenkins AJ,Virella G,DCCT\/EDIC Study Group.

    更新日期:2012-06-01 00:00:00

  • Sleep Disturbances and Glucose Metabolism in Older Adults: The Cardiovascular Health Study.

    abstract:OBJECTIVE:We examined the associations of symptoms of sleep-disordered breathing (SDB), which was defined as loud snoring, stopping breathing for a while during sleep, and daytime sleepiness, and insomnia with glucose metabolism and incident type 2 diabetes in older adults. RESEARCH DESIGN AND METHODS:Between 1989 and...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc15-0137

    authors: Strand LB,Carnethon M,Biggs ML,Djoussé L,Kaplan RC,Siscovick DS,Robbins JA,Redline S,Patel SR,Janszky I,Mukamal KJ

    更新日期:2015-11-01 00:00:00

  • Metformin and exercise in type 2 diabetes: examining treatment modality interactions.

    abstract:OBJECTIVE:To determine the effect of metformin on the acute metabolic response to submaximal exercise, the effect of exercise on plasma metformin concentrations, and the interaction between metformin and exercise on the subsequent response to a standardized meal. RESEARCH DESIGN AND METHODS:Ten participants with type ...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc10-2207

    authors: Boulé NG,Robert C,Bell GJ,Johnson ST,Bell RC,Lewanczuk RZ,Gabr RQ,Brocks DR

    更新日期:2011-07-01 00:00:00

  • A Genome-Wide Association Study Identifies Blood Disorder-Related Variants Influencing Hemoglobin A1c With Implications for Glycemic Status in U.S. Hispanics/Latinos.

    abstract:OBJECTIVE:We aimed to identify hemoglobin A1c (HbA1c)-associated genetic variants and examine their implications for glycemic status evaluated by HbA1c in U.S. Hispanics/Latinos with diverse genetic ancestries. RESEARCH DESIGN AND METHODS:We conducted a genome-wide association study (GWAS) of HbA1c in 9,636 U.S. Hispa...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc19-0168

    authors: Moon JY,Louie TL,Jain D,Sofer T,Schurmann C,Below JE,Lai CQ,Aviles-Santa ML,Talavera GA,Smith CE,Petty LE,Bottinger EP,Chen YI,Taylor KD,Daviglus ML,Cai J,Wang T,Tucker KL,Ordovás JM,Hanis CL,Loos RJF,Schneiderm

    更新日期:2019-09-01 00:00:00

  • The effect of vitamin therapy on the progression of coronary artery atherosclerosis varies by haptoglobin type in postmenopausal women.

    abstract:OBJECTIVE:Antioxidant trials have not demonstrated efficacy in slowing cardiovascular disease but could not rule out benefit for specific patient subgroups. Antioxidant therapy reduces LDL oxidizability in haptoglobin 1 allele homozygotes (Hp 1-1), but not in individuals with the haptoglobin 2 allele (Hp 2-1 or Hp 2-2)...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.27.4.925

    authors: Levy AP,Friedenberg P,Lotan R,Ouyang P,Tripputi M,Higginson L,Cobb FR,Tardif JC,Bittner V,Howard BV

    更新日期:2004-04-01 00:00:00

  • Distinct Patterns of Daily Glucose Variability by Pubertal Status in Youth With Type 1 Diabetes.

    abstract:OBJECTIVE:To evaluate glycemia and metrics of glucose variability in youth with type 1 diabetes, and to assess patterns of 24-h glucose variability according to pubertal status. RESEARCH DESIGN AND METHODS:Metrics of glycemia, glucose variability, and glucose patterns were assessed by using 4 weeks of continuous gluco...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc19-0083

    authors: Zhu J,Volkening LK,Laffel LM

    更新日期:2020-01-01 00:00:00

  • Influence of time of day of blood pressure-lowering treatment on cardiovascular risk in hypertensive patients with type 2 diabetes.

    abstract:OBJECTIVE:We prospectively investigated in hypertensive patients with type 2 diabetes if bedtime treatment with ≥1 hypertension medications exerts better blood pressure control and cardiovascular risk reduction than conventional therapy, in which all medications are ingested in the morning. RESEARCH DESIGN AND METHODS...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc11-0297

    authors: Hermida RC,Ayala DE,Mojón A,Fernández JR

    更新日期:2011-06-01 00:00:00

  • The use of insulin pumps with meal bolus alarms in children with type 1 diabetes to improve glycemic control.

    abstract:OBJECTIVE:The aim of this study was to determine whether the use of meal bolus alarms would result in fewer missed meal boluses per week in youth with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) therapy. RESEARCH DESIGN AND METHODS:This was a randomized trial of 48 youth using CSII, who were ...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/diacare.2951012

    authors: Chase HP,Horner B,McFann K,Yetzer H,Gaston J,Banion C,Fiallo-Scharer R,Slover R,Klingensmith G

    更新日期:2006-05-01 00:00:00

  • Blood or urine glucose-based insulin therapy and control of glycemia. Computer-simulation study.

    abstract::Adjustment algorithms for conventional insulin therapy must be tested for safety and efficacy before clinical implementation. We did this by computer simulation. Accordingly, a computer simulator of human intermediary metabolism created 10 randomly chosen diabetic subjects for study. All were well defined with respect...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.13.4.393

    authors: Albisser AM,Sozzi S,Strack TR

    更新日期:1990-04-01 00:00:00

  • Personal and relationship challenges of adults with type 1 diabetes: a qualitative focus group study.

    abstract:OBJECTIVE:Little is known about the psychosocial challenges of adults living with type 1 diabetes or its impact on partner relationships. This qualitative study was undertaken to gain better understanding of these issues. RESEARCH DESIGN AND METHODS:Four focus groups were held, two with adult type 1 diabetic patients ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-1718

    authors: Trief PM,Sandberg JG,Dimmock JA,Forken PJ,Weinstock RS

    更新日期:2013-09-01 00:00:00

  • Risk factors for plantar foot ulcer recurrence in neuropathic diabetic patients.

    abstract:OBJECTIVE:Recurrence of plantar foot ulcers is a common and major problem in diabetes but not well understood. Foot biomechanics and patient behavior may be important. The aim was to identify risk factors for ulcer recurrence and to establish targets for ulcer prevention. RESEARCH DESIGN AND METHODS:As part of a footw...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc13-2470

    authors: Waaijman R,de Haart M,Arts ML,Wever D,Verlouw AJ,Nollet F,Bus SA

    更新日期:2014-06-01 00:00:00

  • Diabetes mellitus in Tohon O'odham pregnancies.

    abstract:OBJECTIVE:To determine the prevalence of diabetes in Tohono O'odham pregnancies, and to assess the efficacy of early prenatal diabetes screening in populations with high rates of diabetes. RESEARCH DESIGN AND METHODS:All Tohono O'odham women receiving prenatal care at the Sells Service Unit who delivered a viable baby...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.16.1.318

    authors: Livingston RC,Bachman-Carter K,Frank C,Mason WB

    更新日期:1993-01-01 00:00:00

  • Maternal serum triglyceride, glucose tolerance, and neonatal birth weight ratio in pregnancy.

    abstract:OBJECTIVE:To determine the value of measuring serum triglyceride (TG) levels early in pregnancy for predicting late-gestation glucose tolerance and neonatal birth weight ratio (BWR) (birth weight corrected for gestational age). RESEARCH DESIGN AND METHODS:The relationships between morning nonfasting TG measured early ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.18.12.1550

    authors: Nolan CJ,Riley SF,Sheedy MT,Walstab JE,Beischer NA

    更新日期:1995-12-01 00:00:00

  • The epidemiology of diabetes in pregnant Native Canadians. A risk profile.

    abstract:OBJECTIVE:The purpose of this study was to determine the prevalence of diabetes in pregnancy (gestational diabetes mellitus [GDM] and NIDDM) and to identify risk factors in the development of GDM in a native population in northwestern Ontario, Canada. RESEARCH DESIGN AND METHODS:A retrospective analysis of 1,305 singl...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.20.9.1422

    authors: Harris SB,Caulfield LE,Sugamori ME,Whalen EA,Henning B

    更新日期:1997-09-01 00:00:00

  • Establishment of a registry and incidence of IDDM in Avellaneda, Argentina.

    abstract:OBJECTIVE:To provide reliable data on the incidence of insulin-dependent diabetes mellitus (IDDM) in children (< 15 years of age) in Avellaneda, Argentina. RESEARCH DESIGN AND METHODS:A registry was established in Avellaneda, Argentina. The first registry was started in 1989, retrospective data collection was updated ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.17.9.1022

    authors: Sereday MS,Martí ML,Damiano MM,Moser ME

    更新日期:1994-09-01 00:00:00

  • Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S.

    abstract:OBJECTIVE:The International Diabetes Federation (IDF) has proposed a new definition of the metabolic syndrome that emphasizes central adiposity as determined by ethnic group-specific thresholds of waist circumference. The objective of this study was to estimate the prevalence of this syndrome using the IDF definition a...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.28.11.2745

    authors: Ford ES

    更新日期:2005-11-01 00:00:00

  • Effects of BAYm 1099, new alpha-glucosidase inhibitor, on acute metabolic responses and metabolic control in NIDDM over 1 mo.

    abstract::To examine the clinical role of BAYm 1099, 15 diet-treated non-insulin-dependent diabetic (NIDDM) subjects were randomized to start drug (50 mg 3 times/day) or placebo after a 4-wk run-in period in a double-blind crossover study. Treatment periods (4 wk) were separated by a 2-wk washout period. During the last week of...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.11.4.337

    authors: Samad AH,Ty Willing TS,Alberti KG,Taylor R

    更新日期:1988-04-01 00:00:00