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Prolonged hyperglycemia damages pancreatic β cells, contributing to the progression of type 2 diabetes. In patients with newly diagnosed diabetes, brief intensive insulin therapy has led to longer-term euglycemia without further pharmacotherapy. Whether this benefit resulted from early elimination of glucotoxicity or from another effect of insulin was unknown.
To extend these findings, investigators in China randomized 382 adults with newly diagnosed type 2 diabetes to receive one of three initial therapies: continuous subcutaneous insulin infusion (CSII, via pump), multiple daily insulin injections (MDI, with bedtime NPH and pre-meal regular insulin), or oral hypoglycemics (a sulfonylurea, metformin, or both). Doses were titrated to achieve…