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KMID : 0388420010110010053
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Konkuk Journal of Medical Sciences
2001 Volume.11 No. 1 p.53 ~ p.66
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Remission in type 2 diabetic patients after continuous subcutaneous insulin infusion treatment
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Choi Eui-Kwang
Choi Soo-Bong
Park Sun-Min
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Abstract
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Background: It is well known that chronic hyperglycemia can deteriorate pancreatic beta cell function and insulin sensitivity in animal and human studies, and the normalization of blood glucose can reverse them. Our purpose of the study was to investigate the remission pattern after treating patients with continuous subcutaneous insulin infusion (CSII) therapy, and compare the clinical characteristics of remitted and non-remitted patients in a retrospective way.
Methods: We selected 91 type 2 diabetic patients who had been admitted to KonKuk University Hospital from January 1993 to August 1993. After hospitalization, all subjects were treated with insulin pump (Sooil, Seoul, Korea) for intensive blood glucose control until remission occurred. Remission is defined as long-term good glycemic control without any medication. After fifteen to seventeen months of CSII therapy, the induction of remission was examined. Serum c-peptide levels, hemoglobin A1c, and serum lipid profiles were measured after hospitalization and before discharge.
Results: Overall 34.4% of all subjects had remission after 53.6±38.9 days of CSII therapy and remission lasted for average 13.6 ±8.9 months during the study periods. Some clinical characteristics of the patients prior to CSII therapy influenced the remission occurrence. The remission was more frequently induced when patients started CSII therapy with insulin pump in younger age, higher body mass index, shorter diabetic duration, lower post-prandial blood glucose levels, higher post-prandial serum c-peptide levels, and less chronic diabetic complications.
Conclusion: These findings suggest that long-term CSII therapy can induce remission in a significant proportion of mild type 2 diabetic patients. Thus, it is desirable that the intensive insulin treatment by CSII is considered as not the last treatment, but an initial management of mild type 2 diabetic patients.
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KEYWORD
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Insulin pump, Remission, Diabetes mellitus, CSII
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