Ethnic Differences in the Glycemic Response to Exogenous Insulin Treatment in the Veterans Affairs Cooperative Study in Type 2 Diabetes Mellitus (VA CSDM)

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Abstract

OBJECTIVE

The Veterans Affairs Cooperative Study in Type 2 Diabetes Mellitus was conducted in NIDDM patients to determine if a significant difference in HbA1c could be achieved between groups receiving standard and intensive treatment. We observed differences in the response to exogenous insulin between African-Americans and other intensively treated patients. Therefore, we assessed the variations of response and correlated factors that might explain such differences.

RESEARCH DESIGN AND METHODS

One hundred fifty-three men aged 40-69 years with NIDDM for RESULTS

Glycemic control improved in all patients with intensive insulin therapy. African-Americans achieved a greater improvement in HbA1c compared with non-African-Americans with a similar increment in insulin. This difference could not be explained by differences in body weight, activity, concomitant use of other medicines, or insulin-secretory capacity of the pancreas.

CONCLUSIONS

We conclude that ethnic differences may exist in the response to insulin therapy. A knowledge of such differences may aid in achieving good glycemic control, especially since minorities have a greater prevalence of and burden from the microvascular complications of diabetes.

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