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Predictors of Long-Term Glycemic Remission After 2-Week Intensive Insulin Treatment in Newly Diagnosed Type 2 Diabetes

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单位: [1]1Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037 China [2] 2Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong 510080, China [3] 3Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong 510000, China [4] 4Department of Endocrinology, Dalian Municipal Central Hospital, Liaoning 116033, China [5] 5Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China [6] 6Department of Endocrinology, Second Xiangya Hospital of Central South University, Changsha 410011, China [7] 7Department of Endocrinology, Peking University Shenzhen Hospital, Guangdong 518036, China [8] 8Department of Endocrinology, West China Hospital, Sichuan University, Sichuan 610041, China [9] 9Department of Endocrinology, Shenzhen Second People’s Hospital, Guangdong 518035, China [10] 10Department of Endocrinology, Peking Union Medical College Hospital, Beijing 100730, China [11] 11Department of Endocrinology, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China [12] 12Department of Endocrinology, Shengjing Hospital of China Medical University, Liaoning 110022, China [13] 13Statistics Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing 100037, China [14] and 14Department of Endocrinology, China–Japan Friendship Hospital, Beijing 100029, China
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Context: Although several studies suggest that improved beta-cell function is a key determinant of glycemic remission in type 2 diabetes, other predictors remain unclear. Objective: The aim of this clamp-based study was to identify predictors of 2-year glycemic remission after short-term intensive insulin treatment. Design: A 2-year follow-up was planned in 124 drug-naive patients with type 2 diabetes who received continuous subcutaneous insulin infusion (CSII) for 2 weeks. Euglycemic-hyperinsulinemic clamps and IV glucose tolerance tests were performed to assess the insulin sensitivity [glucose infusion rate (GIR)] and acute insulin response (AIR) before and after CSII. Results: First-phase insulin secretion was restored, and the GIR was significantly improved (P < 0.0001) after the 2-week CSII. Glycemic remission rates were 47.6% and 30.7% after 12 and 24 months of follow-up, respectively. Cox analysis revealed that a higher post-CSII glucose level [hazard ratio (HR), 1.38; 95% CI, 1.15 to 1.66; P = 0.0005] and older age at diabetes diagnosis (HR, 1.34; 95% CI, 1.05 to 1.72; P= 0.02) accounted for an increased risk of hyperglycemic relapse. A 1 SD increase in the AIR (HR, 0.75; 95% CI, 0.57 to 0.99; P = 0.04), GIR (HR, 0.67; 95% CI, 0.48 to 0.93; P = 0.016) after CSII, and baseline GIR (HR, 0.71; 95% CI, 0.51 to 0.99; P = 0.047) was inversely associated with this risk. Conclusions: Younger age at diabetes diagnosis, higher baseline insulin sensitivity, and lower glucose levels after insulin treatment significantly favored a 2-year glycemic remission. This long-term remission was attributed to both improved insulin sensitivity and enhanced beta-cell function after short-term intensive insulin treatment.

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出版当年[2018]版:
大类 | 2 区 医学
小类 | 2 区 内分泌学与代谢
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 内分泌学与代谢
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出版当年[2017]版:
Q1 ENDOCRINOLOGY & METABOLISM
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Q1 ENDOCRINOLOGY & METABOLISM

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2017版] 出版当年五年平均[2013-2017] 出版前一年[2016版] 出版后一年[2018版]

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第一作者单位: [1]1Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037 China
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通讯机构: [1]1Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037 China [14] and 14Department of Endocrinology, China–Japan Friendship Hospital, Beijing 100029, China [*1]Department of Endocrinology, Fuwai Hospital and Chinese Academy of Medical Sciences, No.167 North Lishi Road, Xicheng District, Beijing 100037, China.
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