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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
1
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pubmed:dateCreated |
1997-4-17
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pubmed:abstractText |
Insulin-requiring diabetes (IRD) is a condition of permanent blood glucose imbalance which occurs despite a regulated diet and treatment with maximum doses of oral anti-diabetic drugs (glibenclamide 15 mg/d + metformin 1,700 mg/d). This report describes the results of a 2-year prospective study in 75 IRD patients treated to eliminate their insulin requirement. All had residual endogenous insulin secretion (REIS) (urinary C peptide > 80 micrograms/24 h and/or basal C peptide > 2.4 ng/ml) and were treated for 10 days by subcutaneous insulin infusion via a portable pump. REIS was measured, and insulin resistance was determined by an insulin tolerance test (ITT) to define their insulin sensitivity index (DG/G) before and after 10-day intensive therapy. The patients were monitored as outpatients, and the attempt at remission was considered to be a failure (F) or a success (S). Thirty of the 75 patients (40%) were in remission at 1 year, and 14/67 (21%) at 2 years. No clinical criterion differentiated successes from failures at 1 year, nor was the initial degree of blood glucose imbalance or the REIS predictive of the metabolic changes that occurred after insulin therapy. However, the drop in the insulin requirement (IR) (-26% for F and -39% for S, p < 0.05) and the increases in the DG/G index (+68 +/- 51% for F and 176 +/- 50% for S, p < 0.01) after insulin therapy were indicative of their condition 1 year later. Receiving operating characteristic curves showed that a 35% decrease in IR and an 80% increase in DG/G were indicative of a successful outcome at 1 year, with a specificity and sensitivity of about 70%. It is concluded that a decrease in daily IR and an increase in the DG/G index during insulin treatment are prognostic indicators of the course of insulin-requiring diabetics after temporary intensive insulin treatment.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Feb
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pubmed:issn |
1262-3636
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
23
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
75-9
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pubmed:dateRevised |
2011-11-17
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pubmed:meshHeading |
pubmed-meshheading:9059770-Diabetes Mellitus, Type 1,
pubmed-meshheading:9059770-Drug Administration Schedule,
pubmed-meshheading:9059770-Female,
pubmed-meshheading:9059770-Humans,
pubmed-meshheading:9059770-Insulin,
pubmed-meshheading:9059770-Male,
pubmed-meshheading:9059770-Middle Aged,
pubmed-meshheading:9059770-Prognosis,
pubmed-meshheading:9059770-Prospective Studies,
pubmed-meshheading:9059770-ROC Curve,
pubmed-meshheading:9059770-Remission Induction,
pubmed-meshheading:9059770-Risk Factors,
pubmed-meshheading:9059770-Sensitivity and Specificity,
pubmed-meshheading:9059770-Treatment Outcome
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pubmed:year |
1997
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pubmed:articleTitle |
Short-term intensive insulin therapy in insulin-requiring diabetes: effectiveness and factors predicting success.
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pubmed:affiliation |
Service de Diabétologie, Maladies Métaboliques, Nutrition, CHU de Nancy, Hôpital Jeanne d'Arc BP 303, Toul, France.
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pubmed:publicationType |
Journal Article,
Clinical Trial
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