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Long-term effects on glycaemic control and beta-cell preservation of early intensive treatment in patients with newly diagnosed type 2 diabetes: A multicentre randomized trial

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dc.contributor.authorChon, S-
dc.contributor.authorRhee, SY-
dc.contributor.authorAhn, KJ-
dc.contributor.authorBaik, SH-
dc.contributor.authorPark, Y-
dc.contributor.authorNam, MS-
dc.contributor.authorLee, KW-
dc.contributor.authorYoo, SJ-
dc.contributor.authorKoh, G-
dc.contributor.authorLee, DH-
dc.contributor.authorKim, YS-
dc.contributor.authorWoo, JT-
dc.contributor.authorKIIT study investigators-
dc.date.accessioned2019-11-13T04:28:19Z-
dc.date.available2019-11-13T04:28:19Z-
dc.date.issued2018-
dc.identifier.issn1462-8902-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/17690-
dc.description.abstractAIM: To determine the effects of early intensive glycaemic control with intensive insulin treatment (IIT) or initial combined oral antidiabetic drug (COAD) therapy on long-term glycaemic control and the preservation of beta-cell function in people with type 2 diabetes mellitus (T2DM).
METHODS: Newly diagnosed drug-naive patients with T2DM from 8 outpatient diabetes centres were randomized to receive either IIT (n = 50: glargine/glulisine) or COAD (n = 47: glimepiride/metformin) as intensive treatment until the termination criteria to ensure euglycaemia were met. After intensive treatment, the patients completed a follow-up period with either lifestyle modification (LSM) alone or rescue therapy to maintain target glycated haemoglobin levels of <7% (53 mmol/mol) up to week 104. The primary outcomes were analysed after excluding participants who were anti-glutamic acid decarboxylase autoantibody-positive.
RESULTS: Both intensive treatment methods were effective for short-term glycaemic control, but improvements in the disposition index (DI) were significantly greater in the IIT group than in the COAD group (P = .021). During the follow-up period after intensive treatment, the two groups significantly differed in rescue method regarding the maintenance of comparable levels of glycaemic control (P = .010) and more participants who received IIT exhibited well-controlled glycaemia with LSM alone. Additionally, the IIT group maintained a higher DI than the COAD group during the follow-up period. Cox regression analysis showed that the IIT method was associated with a 52.5% lower risk of failing to maintain drug-free glycaemic remission compared with the COAD method (P = .015).
CONCLUSIONS: The findings indicate that outpatient clinic-based IIT to ensure euglycaemia in newly diagnosed patients with T2DM might be an effective initial therapeutic option for improvements in beta-cell function and glycaemic control over the long term, without serious adverse events.
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dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHDiabetes Mellitus, Type 2-
dc.subject.MESHDrug Resistance, Multiple-
dc.subject.MESHDrug Therapy, Combination-
dc.subject.MESHFemale-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHGlycated Hemoglobin A-
dc.subject.MESHHospitals, University-
dc.subject.MESHHumans-
dc.subject.MESHHyperglycemia-
dc.subject.MESHHypoglycemia-
dc.subject.MESHHypoglycemic Agents-
dc.subject.MESHInsulin-
dc.subject.MESHInsulin Resistance-
dc.subject.MESHInsulin Secretion-
dc.subject.MESHInsulin-Secreting Cells-
dc.subject.MESHMale-
dc.subject.MESHMetformin-
dc.subject.MESHMiddle Aged-
dc.subject.MESHOutpatient Clinics, Hospital-
dc.subject.MESHRepublic of Korea-
dc.subject.MESHSulfonylurea Compounds-
dc.titleLong-term effects on glycaemic control and beta-cell preservation of early intensive treatment in patients with newly diagnosed type 2 diabetes: A multicentre randomized trial-
dc.typeArticle-
dc.identifier.pmid29272062-
dc.subject.keywordblood glucose-
dc.subject.keywordcombination-
dc.subject.keyworddrug therapy-
dc.subject.keywordglimepiride-
dc.subject.keywordhyperglycaemia-
dc.subject.keywordhypoglycaemic agents-
dc.subject.keywordinsulin glargine-
dc.subject.keywordinsulin glulisine-
dc.subject.keywordKorea-
dc.subject.keywordtype 2 diabetes mellitus-
dc.contributor.affiliatedAuthor이, 관우-
dc.type.localJournal Papers-
dc.identifier.doi10.1111/dom.13196-
dc.citation.titleDiabetes, obesity & metabolism-
dc.citation.volume20-
dc.citation.number5-
dc.citation.date2018-
dc.citation.startPage1121-
dc.citation.endPage1130-
dc.identifier.bibliographicCitationDiabetes, obesity & metabolism, 20(5). : 1121-1130, 2018-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1463-1326-
dc.relation.journalidJ014628902-
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Journal Papers > School of Medicine / Graduate School of Medicine > Endocrinology & Metabolism
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