INITIATE STUDY: Insulin versus Oral Hypoglycemic Agent as Initial Therapy for Newly Diagnosed Diabetes Mellitus Type 2: A Systematic Review and Meta-Analysis

Authors

  • Ma. Marylaine Dujunco Department of Medicine St. Luke's Medical Center Quezon City, Philippines http://orcid.org/0000-0002-7236-1978
  • June Hayrelle Gorriceta Department of Medicine St. Luke's Medical Center Quezon City, Philippines
  • Oliver Allan Dampil Section of Endocrinology and Metabolism St. Luke's Medical Center Quezon City, Philippines
  • Roberto Mirasol Section of Endocrinology and Metabolism St. Luke's Medical Center Quezon City, Philippines

Abstract

Objectives. This study aims to evaluate the effectiveness of initial insulin therapy versus oral hypoglycemic agents in glucose control among newly diagnosed Type 2 diabetes patients.

Methodology. This is a systematic review and meta-analysis of RCTs with quality grade B searched using the medical subject headings (MeSH):  diabetes mellitus type 2, insulin, oral hypoglycemic agent, with adults newly diagnosed with type 2 DM as subjects and given insulin (± metformin) vs. OHA. Results were summarized as graphs and forest plots using the random effects due to foreseen sources of heterogeneity using Review Manager version 5.1. 

Results. Presence of substantial heterogeneity prevents us from making a conclusion. All four studies showed lower post treatment BMI among participants in the insulin treatment arm. An opposite finding was expected as insulin is known to cause weight gain.  Main adverse effect was hypoglycemia.

Conclusion.  Among newly diagnosed type 2 DM patients, there is insufficient evidence for or against the use of insulin compared to oral hypoglycemic agents as initial management in terms of improvement in glycemic control, decrease in insulin resistance, and improvement in beta cell function.

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Author Biographies

Ma. Marylaine Dujunco, Department of Medicine St. Luke's Medical Center Quezon City, Philippines

Department of Medicine

June Hayrelle Gorriceta, Department of Medicine St. Luke's Medical Center Quezon City, Philippines

Department of Medicine

Chief Resident

Oliver Allan Dampil, Section of Endocrinology and Metabolism St. Luke's Medical Center Quezon City, Philippines

Section of Endocrinology and Metabolism

Roberto Mirasol, Section of Endocrinology and Metabolism St. Luke's Medical Center Quezon City, Philippines

Section of Endocrinology and Metabolism

Chairman

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Published

2014-11-29

How to Cite

Dujunco, M. M., Gorriceta, J. H., Dampil, O. A., & Mirasol, R. (2014). INITIATE STUDY: Insulin versus Oral Hypoglycemic Agent as Initial Therapy for Newly Diagnosed Diabetes Mellitus Type 2: A Systematic Review and Meta-Analysis. Journal of the ASEAN Federation of Endocrine Societies, 29(2), 172. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/149

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