Induction of long-term normoglycemia without medication in Korean type 2 diabetes patients after continuous subcutaneous insulin infusion therapy.

Abstract

Our previous studies showed that some Korean type 2 diabetic patients could maintain long-term normal blood glucose control without any medication, referred to as remission after a certain period of normalization of blood glucose level by continuous subcutaneous insulin infusion (CSII) treatment. In this study we determined the clinical characteristics that influenced the induction of remission. Ninety-one type 2 diabetes mellitus (DM) patients were treated with CSII therapy. Follow-up examinations took place monthly, for sixteen months, at an outpatient clinic where blood glucose levels and insulin dosage were monitored. Overall, in 34.4% of all subjects, remission was induced after 53.6 +/- 38.9 days of CSII therapy and lasted for an average of 13.6 +/- 8.9 months during the study period. The total daily insulin dosage given to normalize blood glucose levels reached a maximum dosage at 7.3 +/- 1.2 days and gradually decreased in all subjects. It did not significantly decrease beyond 14.4 +/- 2.7 days of therapy in patients who did not experience remission, but did continuously decrease and reached zero in patients with remission. Remission rates were higher when patients started CSII therapy with a shorter history of diabetes, lower postprandial blood glucose levels, higher body mass index (BMI), and fewer chronic diabetic complications. These findings suggest that CSII therapy can induce remission in a significant proportion of Korean type 2 DM patients. The possibility of remission is higher if the severity of glucose toxicity is lower at the initiation stage of the therapy. It is suggested that CSII therapy might be considered as an early treatment for type 2 diabetic patients.