Effect of insulin versus triple oral therapy on the progression of hepatic steatosis in type 2 diabetes.

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  • Author(s): Lingvay I;Lingvay I; Roe ED; Duong J; Leonard D; Szczepaniak LS
  • Source:
    Journal of investigative medicine : the official publication of the American Federation for Clinical Research [J Investig Med] 2012 Oct; Vol. 60 (7), pp. 1059-63.
  • Publication Type:
    Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: SAGE Publications Country of Publication: England NLM ID: 9501229 Publication Model: Print Cited Medium: Internet ISSN: 1708-8267 (Electronic) Linking ISSN: 10815589 NLM ISO Abbreviation: J Investig Med Subsets: MEDLINE
    • Publication Information:
      Publication: 2023-: [Thousand Oaks] : SAGE Publications
      Original Publication: Thorofare, NJ : Slack, c1994-
    • Subject Terms:
      Disease Progression*; Diabetes Mellitus, Type 2/*complications ; Diabetes Mellitus, Type 2/*drug therapy ; Fatty Liver/*complications ; Fatty Liver/*drug therapy ; Hypoglycemic Agents/*therapeutic use ; Insulin/*therapeutic use; Administration, Oral ; Adult ; Aged ; Female ; Follow-Up Studies ; Glyburide/pharmacology ; Glyburide/therapeutic use ; Humans ; Hypoglycemic Agents/pharmacology ; Insulin/administration & dosage ; Insulin/pharmacology ; Liver/drug effects ; Liver/metabolism ; Liver/pathology ; Male ; Metformin/pharmacology ; Metformin/therapeutic use ; Middle Aged ; Pioglitazone ; Thiazolidinediones/pharmacology ; Thiazolidinediones/therapeutic use ; Triglycerides/metabolism ; Young Adult
    • Abstract:
      Background: Hyperinsulinemia has been associated with hepatic fat deposition and ensuing insulin resistance. It is unknown if treatment with exogenous insulin in patients with type 2 diabetes, who are most prone to hepatic fat accumulation, would promote the occurrence or worsening of nonalcoholic fatty liver disease.
      Methods: Patients with treatment-naive type 2 diabetes (N = 16) were treated with insulin and metformin for a 3-month lead-in period, then assigned triple oral therapy (metformin, glyburide, and pioglitazone) or continued treatment with insulin and metformin. Hepatic triglyceride content (HTC)-measured by magnetic resonance spectroscopy, serum lipids, glucose, liver function tests, and inflammatory and thrombotic biomarkers were followed for a median of 31 months.
      Results: The 45% decline in HTC during the lead-in period persisted through the follow-up period with no difference between treatment groups at the end of the study (5.26 ± 4.21% in the triple oral therapy vs 7.47 ± 7.40% for insulin/metformin), whereas glycemic control was comparable.
      Conclusions: Improvements in HTC with initial insulin/metformin therapy persisted through the median 31-month follow-up period regardless of the treatment. More importantly, insulin-based treatment did not appear to promote or worsen nonalcoholic fatty liver disease.
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    • Grant Information:
      K23RR024470 United States RR NCRR NIH HHS; UL1 RR024982 United States RR NCRR NIH HHS; K23 RR024470 United States RR NCRR NIH HHS; 3UL1 RR024982-05S1 United States RR NCRR NIH HHS; K08 HL083101 United States HL NHLBI NIH HHS
    • Accession Number:
      0 (Hypoglycemic Agents)
      0 (Insulin)
      0 (Thiazolidinediones)
      0 (Triglycerides)
      9100L32L2N (Metformin)
      SX6K58TVWC (Glyburide)
      X4OV71U42S (Pioglitazone)
    • Publication Date:
      Date Created: 20120718 Date Completed: 20130715 Latest Revision: 20211021
    • Publication Date:
      20231215
    • Accession Number:
      PMC3448864
    • Accession Number:
      10.2310/JIM.0b013e3182621c5f
    • Accession Number:
      22801247