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Lower plasma triglycerides are associated with increased need for insulin requirement in poorly controlled Type 2 diabetic patients
Author(s) -
Rigalleau V.,
BailletBlanco L.,
Perlemoine C.,
Salmi L.R.,
Gin H.
Publication year - 2005
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2005.01548.x
Subject(s) - medicine , insulin , diabetes mellitus , triglyceride , endocrinology , type 2 diabetes , confidence interval , type 1 diabetes , proportional hazards model , gastroenterology , cholesterol
Aims To identify factors associated with insulin requirement in Type 2 diabetic patients, and to examine the significance of a normal plasma triglyceride level. Methods One hundred and three poorly controlled (HbA 1c = 9.4 ± 1.9%) Type 2 diabetic patients initially not treated with insulin were followed up for 5 years. Insulin was administered if HbA 1c > 8% despite maximal oral anti‐diabetic treatment and bodyweight control. Variables were compared between insulin requiring and non‐insulin‐treated patients using unpaired t ‐tests. The outcomes of initially normotriglyceridaemic (< 1.7 mmol/l) and hypertriglyceridaemic patients were compared using unpaired t ‐tests, and a survival analysis (Cox proportional hazards model). Results Sixty‐three patients were transferred to insulin. They were 5 years older ( P = 0.004), with a 3‐year longer duration of their diabetes ( P = 0.03), a 1.2% higher HbA 1c ( P = 0.002), and 50% lower triglyceride levels ( P = 0.02) than the others. The survival analysis showed that a long duration of diabetes, a high HbA 1c , and a normal triglyceride level were associated with the need for insulin; the effect of normotriglyceridaemia was significant in the most poorly controlled (HbA 1c > 9.5%) patients (relative risk: 2.35, 95% confidence interval: 1.16–5.52, P = 0.016). The 46 normotriglyceridaemic patients were leaner ( P = 0.0004) and had lower C‐peptide levels ( P = 0.0008) than the others. Despite similar diabetes duration and HBA 1c , more were transferred to insulin (normotriglyceridaemic: 71%, hypertriglyceridaemic: 52%, P = 0.03). Conclusion A normal triglyceride level is associated with a need for insulin in poorly controlled Type 2 diabetes.