Appropriate insulin initiation dosage for insulin-naive type 2 diabetes outpatients receiving insulin monotherapy or in combination with metformin and/or pioglitazone

Background Few studies have given suggestions on appropriate initiation insulin dosage when combined with oral antidiabetic drugs （OADs）. This research was to investigate appropriate initiation insulin doses for insulin-naive type 2diabetes patients with different combinations and the relationship b...

Full description

Saved in:
Bibliographic Details
Published in:Chinese medical journal 2010-12, Vol.123 (24), p.3684-3688
Main Authors: Liao, Lin, Yang, Ming, Qiu, Lu-Lu, Mou, Ya-Ru, Zhao, Jia-Jun, Dong, Jian-Jun
Format: Article
Language:English
Subjects:
2型糖尿病
Adult
Aged
Blood Glucose - analysis
Body Weight - drug effects
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - drug therapy
Drug Therapy, Combination
Female
Humans
Hypoglycemic Agents - administration & dosage
Insulin - administration & dosage
Insulin - adverse effects
Insulin - therapeutic use
Linear Models
Male
Metformin - administration & dosage
Metformin - adverse effects
Middle Aged
Outpatients
Regression Analysis
Thiazolidinediones - administration & dosage
Thiazolidinediones - adverse effects
二甲双胍
吡格列酮
抗糖尿病药物
空腹血糖
胰岛素
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Few studies have given suggestions on appropriate initiation insulin dosage when combined with oral antidiabetic drugs （OADs）. This research was to investigate appropriate initiation insulin doses for insulin-naive type 2diabetes patients with different combinations and the relationship between insulin dosage and relevant factors.Methods This was a randomized, open-label, treat to target study. The target was 20% decrease of both fasting plasma glucose （FPG） and 2 hours post-breakfast blood glucose （P2hBG）. One hundred and forty-seven insulin-naive Chinese patients recruited were randomiy assigned to 3 groups： group A, patients received insulin monotherapy; group B, received insulin plus metformin （0.5 g, tid） and group C, received insulin plus metformin （0.5 g, tid） and pioglitazone （15 mg, qd）.Results Both the time of getting 20% reduction of FPG and P2hBG showed significant differences among the three groups. The time was shortest in Group C. The insulin doses needed to achieve glucose reduction of 20% in three treatment groups were （0.40±0.04） U·kg-1·d-1 for Group A, （0.37±0.04） U·kg-1·d-1 for Group B, and （0.35±0.03） U·kg-1·d-1 for Group C, respectively. Multiple linear stepwise regression analysis showed that insulin doses correlated with body weight, FPG, diabetes duration, age and history of sulfonylurea treatment. The standardized regression coefficients were 0.871, 0.322, 0.089, 0.067 and 0.063 （with all P ＜0.05）.Conclusions To achieve blood glucose＇s reduction of 20% within safety context, initial insulin doses were recommended as the following： 0.40 U·kg-1·d-1 for insulin mono-therapy, 0.37 U·kg-1·d-1 for insulin plus metformin treatment, and 0.35 U·kg-1.d-1 for insulin plus metformin and pioglitazone treatment in Chinese type 2 diabetes outpatients. Body weight is found the most closely related factor to the insulin dosage.
ISSN:0366-6999
2542-5641
DOI:10.3760/cma.j.issn.0366-6999.2010.24.031