EFFECTS OF EARLY INTRODUCTION OF INTENSIVE INSULIN THERAPY ON THE CLINICAL COURSE IN NONOBESE NIDDM PATIENTS

In order to reconsider the extent of indication of insulin therapy in non-insulin dependent diabetes mellitus (NIDDM), we performed the foll owing trial in a prospective fashion. At the beginning phase of treatm ent for diabetes, we introduced intensive insulin therapy in 22 non-ob ese (Body mass index similar to 24 kg/m(2)) NIDDM patients without pro liferative retinopathy, who were selected in a standardized fashion, a voiding any arbitrary choice. None had received oral hypoglycemic agen ts (OHA) or insulin yet. By administering insulin 3 or 4 times a day, strict glycemic control was attained and maintained, and then the insu lin dose was gradually lowered while keeping good glycemic control. In patients whose glycemic control was maintained at an excellent level for more than 7 days under an insulin dosage lower than 8 u/day, insul in therapy was discontinued. As a result, 15 patients (68%) attained g ood glycemic control both without insulin and OHA almost within a mont h and 6 patients (27%) shifted to OHA. It is recommended to introduce intensive insulin therapy in non-obese NIDDM patients without prolifer ative retinopathy and to aim at attaining good glycemic control both w ithout insulin and OHA.