Intensive Insulin Rx Lowers Glycemic Variability in Early DM
(HealthDay News) — 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, MD, PhD, 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-cell function 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% of patients 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% or higher increase in ISSI-2 had a reduction in glucose variability, compared with their peers who had virtually no change (−0.041 vs. −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.