Need for Insulin Therapy in Type II Diabetes Mellitus: A Randomized Trial

Linda M. Frazier, Cynthia D. Mulrow, Lovest T. Alexander, Robert T. Harris, Kathleen R. Heise, J. Trig Brown, John R. Feussner

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

To identify patients with type II diabetes mellitus for whom insulin therapy is most beneficial, we conducted a randomized controlled trial in the general medicine clinic of a university hospital. Asymptomatic, obese, insulin-treated patients were given diet and diabetes education and, in half of these patients, insulin therapy was withdrawn. Over six months, patients developing hyperglycemic symptoms or acetonemia were counted as study failures. Failure criteria developed in 13 of 25 insulin-withdrawal patients, at a median of four weeks after withdrawal, compared with two of 24 control subjects. Elevated stimulated glucose levels predicted the need for insulin therapy. Hyperglycemia worsened in insulin-withdrawal patients who did not meet study failure criteria, but it improved in control patients. Study patients were insulin deficient as shown by low baseline C peptide values (0.43±0.05 nmol/L). The prompt metabolic decompensation precipitated by insulin withdrawal suggests that insulin-deficient patients may benefit from insulin therapy and may need it to prevent symptomatic hyperglycemia.

Original languageEnglish (US)
Pages (from-to)1085-1089
Number of pages5
JournalArchives of Internal Medicine
Volume147
Issue number6
DOIs
StatePublished - Jun 1987

ASJC Scopus subject areas

  • Internal Medicine

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