1. Effect of basal insulin supplement therapy on diabetic retinopathy in short‐duration type 2 diabetes: A one‐year randomized parallel‐group trial
- Author
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Xixiang Tang, Jiong Shu, Shuo Lin, Jing Wang, Panwei Mu, Mengyin Cai, Hua Liang, Bai-Run Lin, Yanming Chen, Yina Wang, Yong-jun Zhang, Man-man Wang, and Ying Tan
- Subjects
Blood Glucose ,Male ,Time Factors ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Administration, Oral ,Insulin Glargine ,Type 2 diabetes ,030204 cardiovascular system & hematology ,0302 clinical medicine ,subsequent therapy ,后续治疗 ,Prospective Studies ,Incidence ,Incidence (epidemiology) ,Diabetic retinopathy ,Middle Aged ,Treatment Outcome ,Original Article ,Drug Therapy, Combination ,Female ,Adult ,China ,medicine.medical_specialty ,Adolescent ,血糖波动 ,030209 endocrinology & metabolism ,Injections ,Young Adult ,03 medical and health sciences ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Hypoglycemic Agents ,basal insulin ,Aged ,Glycemic ,Glycated Hemoglobin ,基础胰岛素 ,Group trial ,Diabetic Retinopathy ,business.industry ,Interleukins ,Insulin ,糖尿病视网膜病变 ,Original Articles ,medicine.disease ,Diabetes Mellitus, Type 2 ,Basal (medicine) ,glycemic variability ,business ,Biomarkers - Abstract
Background In this study, we compared the effect on diabetic retinopathy (DR) between oral antidiabetic drugs (OADs) alone and in combination with basal insulin‐supported OADs therapy (BOT). [Correction added on 11 November 2019, after first online publication: In Abstract under Background section, “DR” has been corrected into “diabetic retinopathy (DR)”.] Methods Between January 2015 and January 2018, this study enrolled 290 patients (age 18‐65 years) with diabetes duration between 0 and 5 years. Patients were randomly assigned to receive OADs or BOT after 14 days intensive insulin treatment. Examinations were performed at the beginning and end of the study. Results Fewer patients developed DR in the BOT than OADs group (8 [6.06%] vs 12 [8.3%], respectively), and all cases of DR were non‐proliferative. Blood glucose concentrations were higher in the BOT than OADs group at the 3rd month, but lower in the former at the 6th and 12th month. The rate of reaching target HbA1c ≤7% was lower in the BOT than OADs group at the 3rd month (63.6% vs 72.2%, respectively), similar between the two groups at the 6th month (60.6% vs 66.6%, respectively) and higher in the BOT group at the 12th month (75.0% vs 61.1%, respectively). The SD of fasting blood glucose (FBG), coefficient of variation of FBG, SD of blood glucose (SDBG), and mean amplitude of glycemic excursions were lower in the BOT than OADs group. Changes in the levels of three cytokines (interleukin [IL]‐1β, IL‐6, and IL‐17α) were significantly less in the BOT than OADs group. Conclusions Twelve months of BOT decreased the incidence of DR in short‐duration type 2 diabetes by reducing glycemia more effectively, stably, and completely than OADs alone., Highlights This study suggests that basal insulin‐supported oral antidiabetic drugs (OADs) therapy is superior to OADs alone in preventing diabetic retinopathy.This will help clinicians to select a suitable subsequent therapy after initial intensive insulin therapy.
- Published
- 2019
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