The withdrawal rate in higher CPR (1.00 ng/ml, n=32) group was clearly higher than that in lower CPR (1.00 ng/ml, n=32) group by Kaplan-Meier estimation (p0.001). BMI and CPR were higher, and duration of diabetes shorter in withdrawal group than those in non-withdrawal group. Twenty-four patients (37.5%) withdrew insulin therapy (withdrawal group) and the rest required insulin therapy (non-withdrawal group) at the end of follow-up. During the 6-month follow-up period, HbA1c significantly improved from 11.11.7% to 6.50.7% and there was no significant difference in HbA1c between insulin regimens. Insulin dosage was adjusted to achieve the goal, FPG 110 mg/dl and prandial plasma glucose 140 mg/dl, and the endpoint of the study was set at a withdrawal of insulin therapy with the glycemic goal and total insulin dosage of 10U/day. Insulin secretion capacity was evaluated by C-peptide (CPR) in glucagon stimulation test. with each mealtime, or basal bolus therapy. Sixty four type 2 diabetic patients (60.010.1 (SD) years old) with poor glycemic control (HbA1c10.0%) and no history of insulin therapy, received intensive insulin therapy, premixed insulin including 50% insulin lispro (Humalog Mix50) t.i.d. The aim of the present study is to investigate whether insulin secretion capacity may predict a withdrawal of insulin therapy by improving glycemic control via intensive insulin therapy in poorly controlled type 2 diabetic patients or not. Although early and intensive insulin therapy is supposed to provide rest and recovery from exhaustion of -cell, clinical evidence is not fully clarified. Insulin Secretion Capacity Predicts Withdrawal of Intensive Insulin Therapy in Poorly Controlled Insulin-Nave Type 2 Diabetic Patients Glucose toxicity by chronic h Glucose toxicity by chronic hyperglycemia causes cell dysfunction and insulin resistance.
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