Recovery of b-Cell Functions with Low-Dose Insulin Therapy: Study in Newly Diagnosed Type 2 Diabetes Mellitus Patients

Abstract

Aim: Insulin therapy induces remission in subjects with newly diagnosed type 2 diabetes mellitus (T2DM). This study assessed the insulin and C-peptide levels in newly diagnosed T2DM subjects during low-dose insulin therapy.

Subjects and Methods: Twenty newly diagnosed, drug-naive, T2DM patients without acute or chronic complications were the subjects for this study. Premixed insulin (70/30), 16 units, as two divided doses, was started for all subjects after preliminary investigations. The same dose of insulin was continued until normoglycemia was achieved. Subsequently the insulin dose was down-titrated. Plasma insulin, C-peptide, and blood glucose (both fasting and after breakfast) were measured at baseline and monthly for 6 months. Body weight and glycosylated hemoglobin (HbA1c) were measured every 3 months and the lipid profile was obtained at baseline and at 6 months.

Results: Blood glucose levels showed a rapid decreasing trend and reached the near-normoglycemic range by 3 months, whereas plasma insulin and C-peptide showed a slow and steady increase until the fourth month and remained the same during the next 2 months of follow-up. HbA1c was 11.31.4% (range, 8.6–13.5%) and 7.050.54% (range, 6.3–8.1%) at the time of diagnosis and at the end of 6 months, respectively. The mean weights of the study subjects at baseline and 3 and 6 months were 7016 kg (range, 44–95 kg), 6813 kg, and 6813 kg (P¼0.083), respectively. Total cholesterol, low-density lipoprotein-cholesterol, and triglycerides decreased, whereas high-density lipoprotein-cholesterol was higher at 6 months.

Conclusion: Low-dose insulin therapy in newly diagnosed T2DM leads to b-cell recovery (as documented by plasma insulin and C-peptide levels) by 3–4 months.