Efficacy of metformin-based oral antidiabetic drugs is not inferior to insulin glargine in newly diagnosed type 2 diabetic patients with severe hyperglycemia after short-term intensive insulin therapy.
BACKGROUND
Insulin therapy should be strongly considered in newly diagnosed type 2 diabetic (T2D) patients with severe hyperglycemia. However, whether insulin be continued or patients switched to an oral antidiabetic drug (OAD) after short-term intensive insulin therapy (ITT) is not clear.


METHODS
After ITT for 10-14 days, 47 patients were randomized into either a glargine (n = 21) or metformin-based OAD (n = 26) group for a 6-month intervention. After these 6 months, patients in the glargine group were switched to metformin-based OAD therapy, whereas treatment in the OAD group was unchanged. Patients were followed-up for another 6 months.


RESULTS
At the end of the 6-month intervention, HbA1c was similarly reduced in both the glargine (from 11.81 ± 1.70% to 6.48 ± 0.79%; P < 0.001) and OAD (from 11.71 ± 1.89% to 6.16 ± 0.52%; P < 0.001) groups. At the end of 12 months, HbA1c was at comparable and near optimal levels in both groups. Similar increases were seen in homeostatic model assessment of β-cell function in the two groups after 6 months. There were no significant differences between the two groups in insulin sensitivity improvement, hypoglycemic episodes, weight change, treatment satisfaction and quality of life after the 6-month intervention.


CONCLUSIONS
The effects of metformin-based OAD therapy on glycemic control and improvements in β-cell function are not inferior to glargine in newly diagnosed T2D patients with severe hyperglycemia after short-term ITT. Considering the superiority of metformin in terms of safety, cost, and convenience, metformin-based OAD therapy is strongly recommended for these patients.
['Cheng|Qingfeng|Q|', 'Yang|Shumin|S|', 'Zhao|Changhong|C|', 'Wang|Zhihong|Z|', 'Feng|Zhengping|Z|', 'Li|Rong|R|', 'Ye|Peng|P|', 'Zhang|Suhua|S|', 'Deng|Huacong|H|', 'Zhou|Bo|B|', 'Long|Jian|J|', 'Gong|Lilin|L|', 'Qing|Hua|H|', 'Luo|Cheng|C|', 'Li|Qifu|Q|']
D000284:Administration, Oral D000328:Adult D000368:Aged D001786:Blood Glucose D002681:China D003924:Diabetes Mellitus, Type 2 D005260:Female D005500:Follow-Up Studies D006442:Glycated Hemoglobin A D006801:Humans D007003:Hypoglycemia D007004:Hypoglycemic Agents D007328:Insulin D000069036:Insulin Glargine D049528:Insulin, Long-Acting D050417:Insulin-Secreting Cells D008297:Male D008687:Metformin D008875:Middle Aged D011379:Prognosis D011788:Quality of Life D012307:Risk Factors
glargine intensive insulin therapy metformin type 2 diabetes mellitus 关键词：甘精胰岛素，胰岛素强化治疗，二甲双胍，2型糖尿病