| Combination-therapy with bedtime nph insulin and sulphonylureas gives similar glycaemic control but lower weight gain than insulin twice daily in patients with type 2 diabetes. | |
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MedLine Citation:
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PMID: 12442064 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To study the effect on body weight and glycaemic control of two insulin treatment regimens in patients with Type 2 diabetes and moderate failure to oral hypoglycaemic agents. METHODS: Sixteen patients treated with oral hypoglycaemic agents (6 men and 10 women) were included in this open-label, randomized, parallel group study. Their age was 62 +/- 2 (mean +/- SEM) years (range 44-79 years), body weight 71.3 +/- 2.9 kg, body mass index (BMI) 24.6 +/- 0.8 kg/m(2). The patients were switched to insulin treatment with bedtime NPH insulin combined with daytime sulphonylurea (combination group) or twice daily injections of a premixed combination of regular human and NPH insulin (insulin twice daily group) with measurements as given below before and after 12 and 24 weeks of treatment. RESULTS: HbA(1c) was lowered from 8.3 +/- 0.3% to 7.0 +/- 0.2% in the insulin twice daily group (p<0.05) and from 8.3 +/- 0.3% to 6.8 +/- 0.5% in the combination group (p<0.03; ns between treatment groups). Body weight increased from 71.7 +/- 4.0 kg to 77.6 +/- 4.4 kg in the insulin twice daily group (p<0.001) and from 70.8 +/- 4.6 kg to 72.7 +/- 5.1 kg in the combination group (ns; p<0.02 between groups). The dose of insulin at 24 weeks in the insulin twice daily group was 45.8 +/- 4.2 U and 29.4 +/- 5.4 U in the combination group (p=0.03). Combination treatment reduced fasting and stimulated C-peptide levels. CONCLUSIONS: Both treatments improved glycaemic control to the same extent but the combination of bedtime NPH insulin and daytime sulphonylurea gave a very small increase of body weight over a 6 months period. We conclude that combination therapy is an attractive alternative when starting insulin treatment in patients with Type 2 diabetes as this is a critical period for weight gain in such patients. |
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Authors:
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P O Olsson; T Lindstr?m |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Diabetes & metabolism Volume: 28 ISSN: 1262-3636 ISO Abbreviation: Diabetes Metab. Publication Date: 2002 Sep |
Date Detail:
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Created Date: 2002-11-20 Completed Date: 2002-12-20 Revised Date: 2010-03-23 |
Medline Journal Info:
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Nlm Unique ID: 9607599 Medline TA: Diabetes Metab Country: France |
Other Details:
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Languages: eng Pagination: 272-7 Citation Subset: IM |
Affiliation:
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Department of Medicine, Karlstad Central Hospital, Sweden. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Aged Blood Glucose / drug effects, metabolism* Body Mass Index Body Weight C-Peptide / blood Diabetes Mellitus, Type 2 / blood, drug therapy*, physiopathology Drug Administration Schedule Drug Therapy, Combination Humans Hypoglycemic Agents / administration & dosage, therapeutic use* Insulin, NPH / therapeutic use* Middle Aged Sulfonylurea Compounds / therapeutic use* Weight Gain / physiology* |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/C-Peptide; 0/Hypoglycemic Agents; 0/Sulfonylurea Compounds; 53027-39-7/Insulin, NPH |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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