Can Type2Diabetes Patients Stop Oral Medications While Maintain Glucose Control At Target Level?

Objective:To clarify in which circumstances can type2diabetes patients maintain glycemic control without oral medication and only with lifestyle intervention through analysis six years follow-up data in diabetes database.Methods:390long term clinic followed-up type2diabetes patients were included in this retrospective research,65among them who achieved glycemic control without oral medication were categorized as withdraw group, the rest325were categorized as treatment group. Through compare clinical parameters such as glucose, lipid, blood pressure, islet function and weight parameters between baseline(entre time), withdraw time (after in intervention) and recent follow-up visit in withdraw group and above clinical parameters between the two groups by univariate and multivariate analysis, to clarify whether and when can type2diabetes patients maintain glycemic control only with lifestyle intervention and baseline factors related to withdraw oral medication. Results:1. The average withdraw time was1.23±0.81years and relapse percentage was14.5%during follow-up period. In withdraw group, glucose, lipid, blood pressure, islet function and weight parameters were all improved in withdraw time compared with baseline(P>0.05), glucose was maintained at target level in recent follow-up visit and other parameters were improved or have no statistical differences compared with in withdraw time; Patients can withdraw oral drugs when TG attained to less than1.7mmol/1(OR=3.38,95%CI=1.38～9.59) and2-hour postprandial C-peptide(2hC-P)/fasting C-peptide (FC-P) attained to larger than3(OR=2.71,95%CI=1.31～5.59) after life style intervention and drug medication;3. Baseline HbA1c less than7%(OR=3.01,95%CI=1.18～6.36), disease duration less than5years (OR=2.74,95%CI=1.41～7.25), Body Mass Index(BMI) less than24(OR=3.51,95%CI=1.11～5.87) and use only one drug in baseline (OR=2.55,95%CI=1.32～6.87) were potential factors related to glycemic control without medication.Conclusions:Partial type2diabetes patients can control glucose without drug medication after long-term follow up with drug therapy and lifestyle intervention.2hC-P/FC-peptide multiplier improved to3times after lifestyle intervention can be indications for eliminating oral hypoglycemic drugs. Factors related to withdraw drugs including baseline HbA1c, disease duration, BMI and number of drugs. Baseline HbA1c less than7%, disease duration less than five years, BMI less than24kg/m2and only use one drug can be used as predictors for eliminating diabetes medications while maintaining glucose at target level.