Effectiveness and Safety of Oral Hypoglycemic Agents as Initial Treatment in Comparison to Insulin Injection in Newly Diagnosed Type 2 Diabetes Mellitus

Abstract

Objective: To explore the effectiveness and safety of oral hypoglycemic agents (OHA) and insulin (INS) therapy as initial treatment in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Subjects and Methods: An retrospective cohort study was conducted between December 2015 and June 2017 in diabetic clinic in Shanghai General Hospital.195 newly diagnosed T2DM were enrolled. 107 subjects received OHA while 88 subjects received insulin therapy of which 39 switched to OHA in 6 months. The general characteristics, HOMA-B and HOMA-IR, the glycemic control, glucose control rate and hypoglycemia were compared between OHA group and INS group. All of those data were compared between continued insulin group and switch to OHA group. Results: 1.The baseline A1C levels were higher and HOMA-B was lower in INS group. While the A1C levels was significantly higher and the rates of glycemic control were significantly lower in INS group than in OHA group after 6 months’ treatment. The incidences of hypoglycemia, changes of BMI were similar in both groups. However, Multiple linear regression analysis indicated that baseline A1C was independently associated with glycemic control (P =0.005). 2. 44.32% patients switched to OHA in INS group in 6 months. This subgroup was younger, had better glycemic control and more male subjects compared with patients who still used insulin. There were no significant differences in terms of A1C, BMI and HOMA-B at baseline, the changes of BMI and rates of hypoglycemia.Binary logistic regression showed that age was significantly associated with continuous usage of insulin. (P=0.005). Conclusion: Our results demonstrate that baseline A1C was negatively associated with glycemic control and the younger the more possibility to switch from insulin to oral hypoglycemic agents in real word setting. Incidences of hypoglycemia were similar in OHA and INS groups. Disclosure X. Chen: None. Y. Wang: None. A. Zhang: None. N. Wang: None. N. Li: None.