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J Diabetes. 2015 Mar;7(2):182-91. doi: 10.1111/1753-0407.12167. Epub 2014 Aug 7.

Efficacy of metformin-based oral antidiabetic drugs is not inferior to insulin glargine in newly diagnosed type 2 diabetic patients with severe hyperglycemia after short-term intensive insulin therapy.

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  • 1Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.



Insulin therapy should be strongly considered in newly diagnosed type 2 diabetic (T2D) patients with severe hyperglycemia. However, whether insulin be continued or patients switched to an oral antidiabetic drug (OAD) after short-term intensive insulin therapy (ITT) is not clear.


After ITT for 10-14 days, 47 patients were randomized into either a glargine (n = 21) or metformin-based OAD (n = 26) group for a 6-month intervention. After these 6 months, patients in the glargine group were switched to metformin-based OAD therapy, whereas treatment in the OAD group was unchanged. Patients were followed-up for another 6 months.


At the end of the 6-month intervention, HbA1c was similarly reduced in both the glargine (from 11.81 ± 1.70% to 6.48 ± 0.79%; P < 0.001) and OAD (from 11.71 ± 1.89% to 6.16 ± 0.52%; P < 0.001) groups. At the end of 12 months, HbA1c was at comparable and near optimal levels in both groups. Similar increases were seen in homeostatic model assessment of β-cell function in the two groups after 6 months. There were no significant differences between the two groups in insulin sensitivity improvement, hypoglycemic episodes, weight change, treatment satisfaction and quality of life after the 6-month intervention.


The effects of metformin-based OAD therapy on glycemic control and improvements in β-cell function are not inferior to glargine in newly diagnosed T2D patients with severe hyperglycemia after short-term ITT. Considering the superiority of metformin in terms of safety, cost, and convenience, metformin-based OAD therapy is strongly recommended for these patients.

© 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.


glargine; intensive insulin therapy; metformin; type 2 diabetes mellitus; 关键词:甘精胰岛素,胰岛素强化治疗,二甲双胍,2型糖尿病

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