Introduction and Objective: To explore whether short-term intensive glucose control can minimize the escalation of treatment in poorly controlled type 2 diabetes.Methods: Patients with poorly controlled type 2 diabetes despite receiving two or more hypoglycemic agents were randomly assigned to three intensive glucose control groups, with a 36-week core period followed by a 24-week extension. Patients in Group BI received 12 weeks of basal insulin combined with oral medications, then discontinued insulin. Patients in Group CI and Group CIW (with wearables) received 1~2 weeks of continuous subcutaneous insulin infusion (CSII), followed by 10 weeks of basal insulin combined with oral medications, after which insulin was discontinued. The targets of glucose control was set at FBG<5.6mmol/l and 2hBG<7.8mmol/l during insulin therapies.Results: A total of 236 patients from 10 nationwide centers were enrolled. At baseline, the mean HbA1c level was 9.39±1.49% and the disease duration was 7.78±4.40 years. By week 36, significant improvements from baseline were observed in glucose control and β-cell function (HbA1c: -2.34%; HOMA-B: +22.90, both P<0.05). Among patients who received transient CSII, 38.50% achieved and maintained HbA1c<7% with only two oral hypoglycemic drugs, whereas this proportion stood at 31.90% for those with non-CSII treatment (P=0.36). This difference reached statistical significance at 60 weeks (38.90% versus 21.50%, P=0.022). The use of wearables did not yield an improvement.Conclusion: Short-term intensive glucose-lowering therapies de-escalate future treatment regimens and effectively improve glucose control and β-cell function in poorly controlled type 2 diabetes, with CSII therapy showing superior efficacy. Wearables lacking glucose monitoring functionality do not aid in glucose control.
L. Xu: None. J. Liu: None. L. Liu: None. Y. Li: None.
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