ArticleCaspian journal of internal medicine2026
Initial treatment for uncontrolled type 2 diabetes: A clinical trial comparing basal insulin and modified-release gliclazide.
Article in Caspian journal of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The global rise of type 2 diabetes (T2D) presents significant healthcare challenges in diagnosis, prevention, and treatment. This study compares basal insulin and modified-release gliclazide to assess their effectiveness in managing glycemic control and other clinical factors in T2D patients. Methods: This open-label, randomized controlled trial included 90 patients with type 2 diabetes mellitus (T2DM) exhibiting poorly controlled glycemic levels (HbA1c > 10%), referred to endocrinology clinic of Imam Khomeini Hospital, Urmia, Iran, between 2023 and 2024. The patients were randomly assigned into one of two intervention groups: the Gliclazide-MR group (n=45), receiving 30 mg of modified-release gliclazide twice daily, or the Basal Insulin group (n=45), receiving basal insulin (detemir or glargine) at a dosage of 0.1--0.3 units per kilogram of body weight. Results: The mean age of participants was 56.4±11.48 years in the gliclazide-MR group and 55.5±13.48 years in the basal insulin group. Baseline demographic characteristics and pre-intervention variables demonstrated no statistically significant differences between the groups (p > 0.05). Both intervention groups exhibited statistically significant reductions in three glycemic indices HbA1c, fasting blood glucose (FBS), and 2-hour postprandial blood glucose (BS2hpp) at the 3-month follow-up compared to baseline (p < 0.001). The gliclazide-MR group demonstrated comparable efficacy to the basal insulin group in reducing these glycemic indices. Conclusion: Both basal insulin and modified-release gliclazide demonstrated efficacy in improving glycemic control in patients with severe hyperglycemia. The optimal treatment choice should be individualized based on patient-specific factors and treatment goals.
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