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 11.3 ± 1.4% (range, 8.6-13.5%) and 7.05 ± 0.54% (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 70 ± 16 kg (range, 44-95 kg), 68 ± 13 kg, and 68 ± 13 kg (P = 0.083), 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 β-cell recovery (as documented by plasma insulin and C-peptide levels) by 3-4 months.