Abstract

A 3-4 week of intensive insulin intervention corrects hyperglycemia, improves insulin secretion, glycemic control, and insulin sensitivity in people with type 2 diabetes mellitus. We assessed the effect of a shorter course of intensive insulin therapy on insulin sensitivity in people with T2DM. Fifteen poorly controlled subjects with severe hyperglycemia were hospitalized and treated with intensive insulin therapy for 7 days. The short insulin tolerance test was performed before and after the insulin intervention. The intervention consisted of a 24-hour intravenous rapid-acting insulin via electric pump followed by multiple daily insulin injection for six days. This study was registered with the National Ethics Committee Ref. N°233/CNE/SE/2010. Fasting glycemia dropped from 385.4 to 134.4 mg/dL. Insulin sensitivity improved significantly after the insulin intervention (1.98 %/min vs. 2.26 %/min; p < 0.001). Total and LDL cholesterol (both p < 0.001) significantly decreased while changes in HDL-cholesterol and triglycerides were not significant. Body mass index increased from 26.4 to 27.0 kg/m2 (p = 0.03), fat mass from 23.1 to 28.2 (p < 0.001) and fat free mass from 50.2 to 54.0 kg (p < 0.001).These results demonstrate that in poorly controlled type 2 diabetes with severe fasting glycemia, a one week course of intensive insulin intervention can improve insulin sensitivity and successfully alleviate glucotoxicity and lipotoxicity.

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