| Predictive characteristics of patients achieving glycaemic control with insulin after sulfonylurea failure. | |
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MedLine Citation:
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PMID: 21923847 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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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-naïve, 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 β-cell function when predicting the response to insulin analogues. |
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Authors:
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Y-H Lee; B-W Lee; S W Chun; B S Cha; H C Lee |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International journal of clinical practice Volume: 65 ISSN: 1742-1241 ISO Abbreviation: Int. J. Clin. Pract. Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-09-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9712381 Medline TA: Int J Clin Pract Country: England |
Other Details:
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Languages: eng Pagination: 1076-84 Citation Subset: IM |
Copyright Information:
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© 2011 Blackwell Publishing Ltd. |
Affiliation:
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Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea Department of Medicine, Graduate School Yonsei University, Seoul, Korea Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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