Baseline determinants of remission of type 2 diabetes in response to short‐term insulin‐based therapy: The pivotal role of beta‐cell function
Authors' conclusion
Beta-cell function is the dominant baseline pathophysiological determinant of the likelihood of achieving remission of diabetes in response to short-term insulin-based therapy.
Study context
- Population
- Adults with T2D of less than 7 years duration randomized to 8 weeks of insulin glargine, glargine + thrice-daily lispro, or glargine + twice-daily exenatide, followed by 12 weeks of washout
- Participants
- 90 adults
- Comparison
- Remission vs non-remission after short-term insulin-based therapy: baseline determinants
- Remissionn = 31
- Primary endpoint
- Baseline determinants of diabetes remission (HbA1c < 6.5% after ≥ 3 months without glucose-lowering therapy)
- Follow-up
- After 12 weeks of washout
Primary result
As reported in the abstract
Baseline beta-cell function as predictor of remission (logistic regression)
Each group vs non-remissionEstimate (95% CI)
Remission
aOR per log ISSI-2 4.41(1.71–11.34)
Remission
aOR per log insulinogenic index/HOMA-IR 2.21(1.26–3.89)
Remission
aOR per log ΔC-peptide0-120 /Δglucose0-120 × Matsuda 1.62(1.00–2.64)
Remission
aOR per log ΔISR0-120 /Δgluc0-120 × Matsuda 1.87(1.09–3.23)
- Remission achieved
- 31 of 90 participants (34.4%)
- Remission had better baseline beta-cell function (all four measures)
- P ≤ 0.01
- Remission had lower baseline HbA1c
- P < 0.001
Further findings
Time to glycaemic relapse after cessation of therapy by baseline ISSI-2 tertile
- Higher baseline ISSI-2 tertile predicted longer time to relapse
- log-rank P = .029
Original publication
Baseline determinants of remission of type 2 diabetes in response to short‐term insulin‐based therapy: The pivotal role of beta‐cell function. Diabetes Obes Metab. Published 28 June 2023. doi:10.
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