Document Detail


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.
MedLine Citation:
PMID:  12442064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
P O Olsson; T Lindstr?m
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Diabetes & metabolism     Volume:  28     ISSN:  1262-3636     ISO Abbreviation:  Diabetes Metab.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-11-20     Completed Date:  2002-12-20     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  9607599     Medline TA:  Diabetes Metab     Country:  France    
Other Details:
Languages:  eng     Pagination:  272-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, Karlstad Central Hospital, Sweden.
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MeSH Terms
Descriptor/Qualifier:
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:
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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