ß-Cell Function and Glycemic Control in Newly Diagnosed Type 2 Diabetic Patients With Moderate Hyperglycemia
ß-Cell Function and Glycemic Control in Newly Diagnosed Type 2 Diabetic Patients With Moderate Hyperglycemia
We have found that a 6-month course of insulin therapy after a short-term intensive insulin
 therapy could shorten the period of hyperglycemia to preserve ß-cell function and further
 improve long-term glycemic control in recently diagnosed type 2 diabetes with severe
 hyperglycemia (>300 mg/dl, with HBA1C level around 9-11%) in our previous study. We thus
 hypothesized that a 6-month course of basal insulin therapy could also help to preserve
 ß-cell function in newly diagnosed type 2 diabetes with moderate hyperglycemia (200-300
 mg/dl). This prospective study is outpatient-based to evaluate whether 6-month basal insulin
 therapy versus oral anti-diabetic treatment (Metformin and sitagliptin) soon after the
 diagnosis of type 2 diabetes with moderate hyperglycemia (200-300 mg/dl) is associated with
 better ß-cell function reservation. We skip a short-term intensive admission course of
 insulin therapy as our previous study in newly diagnosed type 2 diabetes with severe
 hyperglycemia.
ß-Cell dysfunction and decreased insulin sensitivity are the main pathophysiological defects
 responsible for the development of hyperglycemia. There is a progressive deterioration in
 ß-cell function and mass in type 2 diabetics. Optimal metabolic control, especially early
 intensive glycemic control, plays a role in the prevention of progressive ß-cell dysfunction
 and possibly destruction of the ß-cells with worsening of diabetes.

 We have found that a 6-month course of insulin therapy after a short-term intensive insulin
 therapy could shorten the period of hyperglycemia to preserve ß-cell function and further
 improve long-term glycemic control in recently diagnosed type 2 diabetes with severe
 hyperglycemia (>300 mg/dl, with HBA1C level around 9-11%) in our previous study. We thus
 hypothesized that a 6-month course of basal insulin therapy could also help to preserve
 ß-cell function in newly diagnosed type 2 diabetes with moderate hyperglycemia (200-300
 mg/dl). This prospective study is outpatient-based to evaluate whether 6-month basal insulin
 therapy versus oral anti-diabetic treatment (Metformin and sitagliptin) soon after the
 diagnosis of type 2 diabetes with moderate hyperglycemia (200-300 mg/dl) is associated with
 better ß-cell function reservation. We skip a short-term intensive admission course of
 insulin therapy as our previous study in newly diagnosed type 2 diabetes with severe
 hyperglycemia.

 This study also can assess what readily available parameter would predict which patients will
 achieve long-term successful glycemic control after correction of glucose toxicity.

 Our results will provide evidence that a 6-month course of basal insulin therapy could
 shorten the exposure to moderate hyperglycemia and further improve beta-cell function to
 achieve long-term glycemic control.
Inclusion Criteria:

 1. Recently diagnosed type 2 diabetic patients.

 2. Fasting plasma glucose between 200-300 mg/dl (A1C level between 7% and 10%).

 3. Those who age between 30 and 80 years old and can inject insulin by themselves.

 Exclusion Criteria:

 1. Previous treated with anti-diabetic medication

 2. Pregnant or nursing women.

 3. Impaired liver function (ALT > 120 U/L)

 4. Impaired renal function (Serum creatinine >1.5 mg/dL in male, >1.4 mg/dL in female )

 5. Recently suffered from MI or CVA.

 6. Patients are acute intercurrent illness.

 7. 2-hour C-peptide level < 1.8 ng/mL.