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  • Insulin versus a combination of insulin and sulfonylurea in the treatment of NIDDM patients with secondary oral failure
    Ravnik-Oblak, Maja ; Mrevlje, Franc, 1946-
    Aim: Comparison of the effectiveness of combined therapy vs. an insulin regimen in NIDDM patients with secondary failure of oral hypoglycemic agents. Research design: 27 NIDDM patients were randomly ... allocated to Group A (n = 14,insulin) and Group B (n = 13, insulin and sulfonylurea) with crossover after 3 months. After the next 3 months a decision was made about the further treatment according to the metabolic control. The patients were then treated for another year with the more successful regimen. Metabolic control, residualbeta-cell secretory capacity, degree of peripheral insulin resistance (clamp) and insulin dose were followed during the whole study. Results: (median, interquartile range, in brackets; *, statistically significant difference at P < 0.05): the combined therapy was better than insulin alone in2/3 of patients. Glycemic control was better (HbA1c at 3 months: Group A = 7.9(1.1)% vs. Group B = 7.0(0.5)%*; HbA1c at 6 months: Group A = 7.4(1.5)% vs.Group B = 8.1(1.5)%. Insulin dose was lower during the combined therapy in the first 3 months: Group A = 0.62(0.18) U/kg body weight vs. Group B = 0.39(0.16) U/kg body weight*. Combined treatment was associated with increasedC-peptide excretion both fasting and postprandially. No significant differences in peripheral insulin resistance were noted between the two groups. The combined treatment remained successful even after one year. The two groups of patients with different effective treatment did not differ significantly in any of the observed parameters. Conclusions: the combined therapy was more effective than insulin alone. Its favourable effect persistedafter treatment for a year. It seems better to start the treatment ofthe oral failure with combined therapy compared with insulin first and laterfollowed by combined therapy. On the basis of the observed parameters it is impossible to determine in advance which kind of treatment is more suitablef
    Source: Diabetes research and clinical practice. - ISSN 0168-8227 (Letn. 30, št. 1, 1995, str. 27-35)
    Type of material - article, component part
    Publish date - 1995
    Language - english
    COBISS.SI-ID - 16761561

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