Short-term intensive insulin therapy for newly diagnosed type 2 diabetes mellitus patients is a common treatment method in some hospitals in China, originating from two articles published by Professors Ji Linong and Weng Jianping in the Chinese Journal of Diabetes in November 2003, in which they conducted 2 weeks of intensive insulin therapy for two groups of newly diagnosed type 2 diabetes mellitus patients in Beijing and Guangzhou, respectively, with remission rates reaching 50 – 70%, and some patients could be six months to several years to completely discontinue glucose-lowering drugs.
This is due to the fact that in patients with new-onset type 2 diabetes the pancreatic islet beta cells still have compensatory function even if they are more than 50% damaged, and when blood glucose rises more, the excessive blood glucose inhibits the beta cell response to blood glucose stimulation and secretion (high glucose toxicity). After the administration of exogenous insulin for intensive glucose lowering, the β-cells restore part of the secretory function, and the diabetes is relieved, or even stopped. In patients with longer duration of disease, the number of islet beta cells is reduced due to further damage and apoptosis, and long-term insulin therapy is required.
In 2009, the American Association of Endocrinology (AACE) and in 2010, the Chinese Diabetes Association Diabetes Clinical Guidelines recommended that newly diagnosed type 2 diabetes patients with glycosylated hemoglobin (HbAlc) levels >9% after short-term lifestyle interventions can start treatment with insulin directly. 2014, Chinese diabetes experts reached a consensus that newly diagnosed type 2 diabetes, such as HbAlc >9, or fasting blood glucose >11.1mmol/L, it is recommended that insulin be intensively treated for 2-3 weeks and discontinued or switched to oral hypoglycemic agents after remission is achieved. islet function will be assessed and treatment regimen revised after 3 months, and only a portion of the population can stop or reduce medication due to the average remission rate of about 50%.
Those who stop medication in pursuit of cure, or directly long-term insulin intensive therapy, or even buy pump therapy are thinking one-sidedly. You should ask a professional physician to develop a reasonable long-term treatment plan according to the different islet function status.