{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:49:45Z","timestamp":1791931785522,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000041","name":"American Diabetes Association","doi-asserted-by":"publisher","award":["DK103841"],"award-info":[{"award-number":["DK103841"]}],"id":[{"id":"10.13039\/100000041","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To identify predictors of response to glucose\u2010lowering therapy in patients with new\u2010onset diabetes and very high HbA1c (&gt;10%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study included EDICT participants with an initial HbA1c of more than 10% (N = 104). All subjects received a 75\u2010g oral glucose tolerance test (OGTT) before initiation of therapy, and then were randomized to receive: (a) initial triple therapy with metformin, pioglitazone and exenatide versus (b) stepwise conventional therapy with metformin followed by glipizide and then glargine insulin to reduce HbA1c to less than 6.5%. Insulin secretion and insulin resistance were calculated with OGTT\u2010derived indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010one per cent of participants in the conventional therapy group achieved HbA1c of less than 6.5% at 6 months without need of insulin therapy compared with 78% in the triple therapy group (\n                      <jats:italic>P<\/jats:italic>\n                      = NS). Insulin secretion at baseline was the strongest predictor of subjects who did not require insulin therapy; a cut point of CPEP\n                      <jats:sub>120<\/jats:sub>\n                      \/CPEP\n                      <jats:sub>0<\/jats:sub>\n                      \u2014the ratio between plasma C\u2010peptide concentration at 120\u2009minutes during the OGTT and fasting plasma C\u2010peptide concentration\u2014of more than 1.7 predicted subjects who achieved the treatment target without insulin, irrespective of the fasting plasma glucose (FPG) concentration and whether or not they were started on conventional or triple therapy. Subjects with a CPEP\n                      <jats:sub>120<\/jats:sub>\n                      \/CPEP\n                      <jats:sub>0<\/jats:sub>\n                      of less than 1.7 plus FPG of 269\u2009mg\/dL or less (\u226414.9\u2009mmoL\/L) also achieved the treatment goal with triple therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Insulin secretion in response to a 75\u2010g OGTT predicts the need for insulin therapy at the time of type 2 diabetes (T2D) diagnosis. A cut point of 1.7 of CPEP\n                      <jats:sub>120<\/jats:sub>\n                      \/CPEP\n                      <jats:sub>0<\/jats:sub>\n                      provides a useful clinical tool to individualize glucose\u2010lowering therapy in patients with new\u2010onset T2D and HbA1c of more than 10%.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.14383","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T23:36:38Z","timestamp":1618443398000},"page":"1631-1639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Insulin secretion is a strong predictor for need of insulin therapy in patients with new\u2010onset diabetes and\n                    <scp>HbA1c of more than 10%: A<\/scp>\n                    post hoc analysis of the\n                    <scp>EDICT<\/scp>\n                    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