In order to investigate the influencing factors of continuous subcutaneous insulin infusion (CSII) of 48 newly diagnosed T2DM patients without hypoglycemic agents were analyzed. The enrolled patients were 46.1±9.1 years in age, with a BMI of 25.2±2.8 kg/m2, FPG of 11.6±3.2mmol/L, PPG of 17.4±6.5mmol/L, and HbA1c of 10.8±2.1%. Glucose levels and beta cell function were measured at baseline. An intravenous glucose tolerance test (IVGTT) using 25g of glucose (50ml of 50% glucose) was conducted to assess acute insulin response (AIR) as beta cell function. Serum insulin levels before and 1, 2, 4, 6, and 10 min after glucose injection were measured, and AIR was calculated as the incremental trapezoidal area. The initial insulin dosages of CSII were 0.5-0.7IU/kg according to clinical experience. The insulin dosages were adjusted to achieve euglycemia which was defined as fasting glucose between 4.4 and 6.0 mmol/L and postprandial glucose between 4.4 and 8.0mmol/L as capillary blood glucose values were measured including fasting, premeal and postprandial. CSII therapies were maintained for 14 days and fasting C peptide was measured at 7th day after achieving glycemic targets. The patients achieved glycemic control in 3(3) days. Baseline FPG, PPG, HbA1c, and HOMA-IR were positive related to the days spent to euglycemia (r=0.402, p=0.0and r=0.334, p=0.029 and r=0.352, p=0.015, and r=0.306, p=0.035, respectively). AIR was negative related (r=-0.457, p=0.001). The initial insulin dosages were not associated with the days of achieving glycemic control. The incidents of hypoglycemia of all patients were 3(3) times, which were negative related to C peptide level at 7th day after achieving euglycemia (r=-0.333, p=0.021).
In conclusion, the patients with lower baseline glucose levels and better beta cell function were preferred to achieve glycemic control in shorter time during IIT. The suppression of endogenous insulin secretion was associated with exposure of hypoglycemia.
W. Ke: None. L. Liu: None. Y. Li: None.