en Internal Internal Original Article Original Article <p style="text-align:justify"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="background-color:white"><span sans-serif=""><span style="color:#0033ff;"><em><strong><span new="" roman="" times="">Background: </span></strong></em></span><span new="" roman="" times=""><span style="color:#222222">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.</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="background-color:white"><span sans-serif=""><strong><span new="" roman="" times=""><em><span style="color:#0033ff;">Methods:</span></em><span style="color:#222222"> </span></span></strong><span new="" roman="" times=""><span style="color:#222222">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&ndash;0.3 units per kilogram of body weight.</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="background-color:white"><span sans-serif=""><strong><span new="" roman="" times=""><span style="color:#0033ff;"><em>Results:</em></span><span style="color:#222222"> </span></span></strong><span new="" roman="" times=""><span style="color:#222222">The mean age of participants was 56.4 &plusmn; 11.48 years in the gliclazide-MR group and 55.5 &plusmn; 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&mdash;HbA1c, fasting blood glucose (FBS), and 2-hour postprandial blood glucose (BS2hpp)&mdash;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.</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="background-color:white"><span sans-serif=""><strong><span new="" roman="" times=""><span style="color:#0033ff;"><em>Conclusion:</em></span><span style="color:#222222"> </span></span></strong><span new="" roman="" times=""><span style="color:#222222">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.</span></span></span></span></span></span></p> Hyperglycemia, Type 2 Diabetes, Basal Insulin, Modified-Release Gliclazide 10 0 http://caspjim.com/browse.php?a_code=A-10-3735-1&slc_lang=en&sid=1 Ebrahim Mohammadi dremohammadi90@gmail.com 100319475328460056448 0009-0006-1368-4212 Yes Department of Internal Medicine, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran Laya Hooshmand Gharebagh laya.hooshmand58@gmail.com 100319475328460056449 100319475328460056449 No Department of Internal Medicine, Medicine Faculty, Urmia University of Medical Sciences, Urmia, Iran Maryam Hajiesmaello mhajiesmaello@yahoo.com 100319475328460056450 100319475328460056450 No Palliative Care Research Center, Urmia Branch, Islamic Azad University, Urmia, Iran