The Impact of Different Initial Insulin Dose Regimens in Short-Term Intensive Insulin Therapy

Abstract

Objective: To compare the effects of different initial insulin dose regimens during the short-term insulin intensive treatment in newly diagnosed type 2 diabetes patients, in order to investigate the rational of formula based initiation regimen. Methods: Fifty six patients with newly diagnosed type 2 diabetes, 33 males and 23 females, aged 27-65 years old, BMI 25.43 ± 2.90 kg/m2, were randomly assigned into 2 groups: the formula group (whose insulin dose was initiated according to the formula recommended in our previous study, 28 cases) and the empirical group (according to current guidelines, 28 cases). Short-term intensive insulin therapy was performed, and the glycemic goal was gradually achieved. The time to glycemic goal(TGG), TDD-1, the frequency of hypoglycemia and the glycemic variability were compared. Results: The average TGG in the formula group(2.68 ± 1.44 days) is shorter than that in the empirical group (3.61 ± 1.60 days, P <0.05). There is no significant difference in the initial insulin dose (44.28 ± 9.10 IU, P> 0.05) of the formula group compared with the TDD-1 (46.91 ± 13.26 IU), whereas the initial insulin dose (34.09 ± 5.21 IU, P <0.05)of the empirical group is less than TDD-1. Compared with the TDD-1, while 70% of the estimate TDD-1(eTDD-1),which is calculated according to the formula as the initial insulin regimen,may not meet the requirements (P <0.001), 100% of the eTDD-1 is also too much for them (P <0.001).All the indicators for glycemic variability such as mean MBG, MGSD, M value, MAGE and LAGE during the initial three days are not significantly different between the two groups (P> 0.05). There is also no significant difference between 2 groups in the incidence of hypoglycemia(P> 0.05). Conclusion: Formula based initial insulin regimen is helpful in shortening TGG without increasing within-day glycemic variability or hypoglycemia events.It is recommended that 80% of the eTDD-1 can be used as the initial insulin regimen for the intensive treatment in most newly diagnosed T2DM patients. Disclosure H. Xinwei: None.