Remission of T2D Possible With Strict Glycemic Control

HealthDay News — Stricter glycemic control during short-term intensive insulin therapy for newly diagnosed type 2 diabetes patients is associated with a higher likelihood of remission at 1 year, according to a study published online in the Journal of Diabetes Investigation.

Liehua Liu, MD, PhD, from First Affiliated Hospital of Sun Yat-Sen University in China, and colleagues sought to determine optimal glycemic targets during short-term intensive insulin therapy in patients with newly diagnosed type 2 diabetes.

Insulin pumps were used to achieve and maintain glycemic targets (fasting blood glucose < 6.1 mmol/L; 2-hour post-prandial blood glucose < 8 mmol/L) for 14 days. Daily 8-point capillary blood glucose profiles were recorded.

The researchers found that mean blood glucose was independently associated with improving acute insulin response (P =.015) and 1-year remission (odds ratio, 0.12) but negatively associated with more Level-1 hypoglycemia (P =.001).

Major hypoglycemia was rare. Patients in the middle and lower mean blood glucose tertiles had higher 1-year remission rates vs the upper tertile (68.7% and 75% vs 32.3%; both P <.001). Compared with the upper tertile, only the middle tertile did not have increased hypoglycemia (P =.48).

“Based on glycemic parameters in the middle mean tertile, we propose new glycemic targets that are about 0.4 mmol/L lower than current ones as long-term benefit outweighs short-term risks,” the authors write.

Reference

Liu L, Liu J, Xu L, et al. Lower mean blood glucose during short-term intensive insulin therapy is associated with long-term glycemic remission in patients with newly diagnosed type 2 diabetes: evidence-based recommendations for standardization [published online November 30, 2017]. J Diabetes Investig. doi: 10.1111/jdi.12782