Intensive insulin rx lowers glycemic variability in early DM

Intensive insulin rx lowers glycemic variability in early DM

(HealthDay)—Short-term intensive insulin therapy (IIT) can improve β-cell function in type 2 diabetes mellitus (T2DM) in association with decreased glycemic variability, according to a study published in the April issue of Diabetes Care.

Caroline K. Kramer, M.D., Ph.D., from Mount Sinai Hospital in Toronto, and colleagues examined whether β-cell functional recovery induced by short-term IIT correlated with glycemic variability. Sixty-one patients with T2DM (mean duration, three years) underwent four weeks of IIT. β- was assessed with the Insulin Secretion-Sensitivity Index-2 (ISSI-2) before and after IIT. Glucose variability was measured in the first and last week by the coefficient of variation of capillary glucose.

The researchers found that 55.7 percent of had a reduction in their glucose variability between the first and last week on IIT. There was a negative correlation between change in glucose variability and the change in β-cell function (P = 0.008). The only factor independently associated with the change in glucose variability was percentage change in ISSI-2 (P = 0.03). Patients with a 25 percent or higher increase in ISSI-2 had a reduction in glucose variability, compared with their peers who had virtually no change (−0.041 versus −0.0002; P = 0.006).

"It thus emerges that early in the course of T2DM, glucose variability is a modifiable parameter for which intervention may mitigate future risk of adverse outcomes," the authors write.

Two authors disclosed financial ties to Novo Nordisk, which funded the study.


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