110-LB: The Comparison of Glycemic Remission and Nonremission Patients after Sitagliptin Combination with Short-Term Intensive Insulin Therapy

Abstract

Short-term intensive insulin therapy (IIT) could induce long-term glycemic remission. Sitagliptin increased endogenous GLP-1 content to achieved glucose control. The combination of sitagliptin with IIT might enhance the effect of improving alpha cell and beta cell function. 72 newly diagnosed type 2 diabetes patients with hypoglycemic therapy naïve were enrolled, with 47.6±9.0 years in age, with BMI of 25.2±2.7 kg/m2, FPG of 11.1±3.4mmol/L, and HbA1c of 10.6±2.3%. Continuous subcutaneous insulin infusion (CSII) were used as IIT, which were maintained for 14 days after patients achieving euglycemia. The treatment course of sitagliptin was 90 days. After cessation of sitagliptin, 45.8% of patients (33/72) achieved 1-year glycemic remission without any hypoglycemic medications. Compared the baseline of remission and non-remission groups, the baseline fasting plasma glucose (FPG) of remission group was lower (10.0±3.0 vs. 12.0±3.5mmol/L, p=0.012), but the levels of HbA1c, acute insulin response (AIR), HOMA-B and HOMA IR were not different between groups. After CSII cessation, FPG of remission group was still lower than non-remission group (5.8±0.8 vs. 6.9±1.1mmol/L, p<0.001), beta cell function and insulin resistance were improved significantly(HOMA-B: 62.96(25.94) vs. 40.67(41.79), p=0.026; HOMA-IR: 1.56(0.54) vs. 1.74(0.99), p=0.003). Analyzed insulin dosage of the 14th day after achieving glycemic target, basal insulin dosage was lower in remission group (9.6±5.6IU/d, vs. 14.4±7.1IU/d, p=0.002). In conclusion, lower levels of FPG at baseline and after IIT, less basal insulin usage during IIT, and better improvement of beta-cell function and insulin resistance suggested the possibility of glycemic remission after combination of IIT and sitagliptin therapy. Disclosure W. Ke: None. L. Liu: None. X. He: None. Y. Li: None.