Improvement of β-cell function ameliorated glycemic variability in patients with newly diagnosed type 2 diabetes after short-term continuous subcutaneous insulin infusion or in combination with sitagliptin treatment: a randomized control trial

Guoyue Yuan; Hao Hu; Su Wang; Qichao Yang; Shuqin Yu; Wenjun Sun; Weiyun Qian; Caoming Mao; Libin Zhou; Dezhi Chen; Zhaoling Wang; Qin Gong; Dong Wang

doi:10.1507/endocrj.EJ15-0160

ORIGINALS

Improvement of β-cell function ameliorated glycemic variability in patients with newly diagnosed type 2 diabetes after short-term continuous subcutaneous insulin infusion or in combination with sitagliptin treatment: a randomized control trial

Guoyue Yuan, Hao Hu, Su Wang, Qichao Yang, Shuqin Yu, Wenjun Sun, Weiyun Qian, Caoming Mao, Libin Zhou, Dezhi Chen, Zhaoling Wang, Qin Gong, Dong Wang

Author information

Guoyue Yuan
Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
Hao Hu
Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
Department of Endocrinology, the First people’s Hospital of Xuzhou, Xuzhou, China
Su Wang
Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
Qichao Yang
Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
Shuqin Yu
Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
Wenjun Sun
Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
Weiyun Qian
Department of Endocrinology, the Third Affiliated Hospital of Suchow University, Changzhou, China
Caoming Mao
Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China
Libin Zhou
Ruijin Hospital, Center of Molecular Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Jiaotong University Medical School, Shanghai, China
Dezhi Chen
Department of Endocrinology, the First people’s Hospital of Xuzhou, Xuzhou, China
Zhaoling Wang
Department of Endocrinology, the First people’s Hospital of Xuzhou, Xuzhou, China
Qin Gong
Department of Endocrinology, the First people’s Hospital of Suqian, Suqian, China
Dong Wang
Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, China

Keywords: β-cell function, Glycemic variability, Continuous subcutaneous insulin infusion, Sitagliptin, Type 2 diabetes

JOURNAL FREE ACCESS

2015 Volume 62 Issue 9 Pages 817-834

DOI https://doi.org/10.1507/endocrj.EJ15-0160

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Abstract

Glycemic variability (GV) has been proposed as contributor to diabetes-related macrovascular complications. This randomized control trial evaluated a new combination therapy with continuous subcutaneous insulin infusion (CSII) plus sitagliptin (CSII + sitagliptin) vs. CSII only in terms of metabolic control, GV and β-cell function in patients with newly diagnosed type 2 diabetes (T2DM). 217 patients were randomized to two weeks of CSII (n = 108) or CSII + sitagliptin (n = 109) therapy. As a measure of GV, the coefficient of variation (CV) was computed from capillary blood glucose during the first and second week, respectively. β-cell function before and after treatment was determined with the Insulin Secretion-Sensitivity Index-2 (ISSI-2). Good metabolic controls were established with both therapies. CSII + sitagliptin therapy resulted in greater improvements in CV and ISSI-2 than CSII alone (all P = 0.000). For each group, change in CV was inversely correlated with change in ISSI-2 (r = -0.529, P = 0.000 and r = -0.433, P = 0.000, respectively). The multivariate regression analysis demonstrated that improved ISSI-2 was the only independent contributor to reduced CV in both groups (standardized β = -0.388, P = 0.004 and standardized β = -0.472, P = 0.000, respectively). Correction of β-cell function in newly diagnosed T2DM patients via use of either CSII or CSII + sitagliptin therapy was feasible in controlling GV to prevent secondary complications of T2DM. Moreover, CSII + sitagliptin therapy was superior to CSII monotherapy in terms of GV.

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