Insulin secretion is a strong predictor for need of insulin therapy in patients with new-onset diabetes and HbA1c of more than 10%: A post hoc analysis of the EDICT study.


Journal

Diabetes, obesity & metabolism
ISSN: 1463-1326
Titre abrégé: Diabetes Obes Metab
Pays: England
ID NLM: 100883645

Informations de publication

Date de publication:
07 2021
Historique:
revised: 08 03 2021
received: 27 12 2020
accepted: 19 03 2021
pubmed: 15 4 2021
medline: 1 7 2021
entrez: 14 4 2021
Statut: ppublish

Résumé

To identify predictors of response to glucose-lowering therapy in patients with new-onset diabetes and very high HbA1c (>10%). The study included EDICT participants with an initial HbA1c of more than 10% (N = 104). All subjects received a 75-g oral glucose tolerance test (OGTT) before initiation of therapy, and then were randomized to receive: (a) initial triple therapy with metformin, pioglitazone and exenatide versus (b) stepwise conventional therapy with metformin followed by glipizide and then glargine insulin to reduce HbA1c to less than 6.5%. Insulin secretion and insulin resistance were calculated with OGTT-derived indices. Sixty-one per cent of participants in the conventional therapy group achieved HbA1c of less than 6.5% at 6 months without need of insulin therapy compared with 78% in the triple therapy group (P = NS). Insulin secretion at baseline was the strongest predictor of subjects who did not require insulin therapy; a cut point of CPEP Insulin secretion in response to a 75-g OGTT predicts the need for insulin therapy at the time of type 2 diabetes (T2D) diagnosis. A cut point of 1.7 of CPEP

Identifiants

pubmed: 33852204
doi: 10.1111/dom.14383
pmc: PMC8238899
mid: NIHMS1707649
doi:

Substances chimiques

Blood Glucose 0
Glycated Hemoglobin A 0
Hypoglycemic Agents 0
Insulin 0

Types de publication

Journal Article Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1631-1639

Subventions

Organisme : NIDDK NIH HHS
ID : R01 DK107680
Pays : United States

Informations de copyright

© 2021 John Wiley & Sons Ltd.

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Auteurs

Siham Abdelgani (S)

Division of Diabetes, University of Texas Health Science Center and Texas Diabetes Institute, San Antonio, Texas, USA.

Curtiss Puckett (C)

Division of Diabetes, University of Texas Health Science Center and Texas Diabetes Institute, San Antonio, Texas, USA.

John Adams (J)

Division of Diabetes, University of Texas Health Science Center and Texas Diabetes Institute, San Antonio, Texas, USA.

Curtis Triplitt (C)

Division of Diabetes, University of Texas Health Science Center and Texas Diabetes Institute, San Antonio, Texas, USA.

Ralph A DeFronzo (RA)

Division of Diabetes, University of Texas Health Science Center and Texas Diabetes Institute, San Antonio, Texas, USA.

Muhammad Abdul-Ghani (M)

Division of Diabetes, University of Texas Health Science Center and Texas Diabetes Institute, San Antonio, Texas, USA.

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