Abstract:
Objective To explore the factors influencing the efficacy of short-term intensive insulin pump therapy in type 2 diabetes mellitus (T
2DM) and to identify the patient population that would benefit the most.
Methods A total of 156 newly diagnosed T
2DM patients admitted to Shangyu People's Hospital of Shaoxing City between December 2022 and May 2024 were enrolled. All patients received 18-21 days of intensive insulin pump therapy. Changes in metabolic indicators and reversal of hyperglycemia were observed. The influencing factors for reversal of hyperglycemia were studied using binary logistic regression analysis.
Results After treatment, all patients showed significant decreases in levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPG), and homeostatic model assessment of insulin resistance (HOMA-IR), along with an increase in homeostatic model assessment of β-cell function (HOMA-β) compared to their baseline levels (
P < 0.05). After treatment, out of 156 patients, 88 achieved reversal of hyperglycemia, while 68 did not. The reversal group demonstrated lower FPG, fasting insulin (FINS), fasting C-peptide (FCP), 2hPG, 2-hour postprandial insulin (2hINS), and HOMA-IR values than the non-reversal group (
P < 0.05). Elevated FPG, FINS, FCP, 2hINS, and HOMA-IR were identified as risk factors for failure to achieve reversal of hyperglycemia (
P < 0.05).
Conclusion High levels of FPG, FINS, FCP, 2hINS, and HOMA-IR are negatively associated with reversal of hyperglycemia. These indicators should be closely monitored when implementing short-term intensive insulin pump therapy.