Abstract

CAN GLUCOSURIA PREDICTS THE REMISSION AT THE TIME OF INSULIN INITIALIZATION AT THE ONSET OF TYPE 2 DIABETES?

Dr. Kapil Deb Lahiri*

Abstract

Context: Short term intensive insulin therapy at the onset of the type 2 diabetes can achieve long term glycaemic control without any medication in some patients but the question remains “who are going to have remission?” Aims: To see whether urine glucose test can be used to predict the remission at the time of insulin initialization at the onset of their type 2 diabetes. Methods and Material: Insulin therapy was initiated at the onset (within one month of diagnosis) of adult type 2 diabetes and continued for 4 weeks in patients whose fasting plasma glucose was more than 250mg/dl and or HbA1c 9% & above at presentation. Subsequently they were either continued with diet & exercise alone or with addition of OHA for 24 weeks. Urine glucose test was done in all patients at the beginning of the study and after 4 weeks and at the end of the study. Results: Fifteen patients were managed with diet and exercise alone to maintain optimal glycaemic control whereas 19 required OHA in addition to diet and exercise. Remission was more in patients with positive urine glucose test (OD = 6.5). More over urine glucose test of 2+ & above were more attributable to remission (OD = 18.2). Conclusions: High glucosuric patients achieved better remission when Insulin therapy was initiated at the onset of the type 2 diabetes.

Keywords: Urine glucose test, Insulin, Remission.