Improved glycemic control with use of oral hypoglycemic therapy with or without insulin.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
D S Bell, M S Mayo

Abstract

To determine whether combination oral hypoglycemic therapy in insulin-using patients with non-insulin-dependent diabetes mellitus (NIDDM) can improve glycemic control for a prolonged period. We expanded and extended an earlier study to include 130 patients with NIDDM for 10 to 30 years who had been using twice-daily mixed insulin for less than 10 years. Reduction and eventual elimination of the insulin therapy and substitution of metformin and a sulfonylurea were attempted. At follow-up visits, patients were weighed, random plasma glucose levels were determined, and glycosylated hemoglobin values were obtained. Of 130 C-peptide-positive patients with NIDDM receiving twice-daily mixed insulin, 100 were successfully transferred to combination oral hypoglycemic therapy with glyburide originally and later glimepiride and metformin--a primary failure rate of 23.1%. Secondary failure occurred in 20 patients after a mean duration of 6.4 months. Two patients with successful conversion to oral combination therapy resumed insulin treatment because of cost. Of the patients with primary failures, 6 had gastrointestinal side effects, 10 were successfully managed on combination oral therapy plus evening mixed insulin, and 14 ultimately recei...Continue Reading

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Citations

Jun 15, 2011·Cellular and Molecular Life Sciences : CMLS·Diethart SchmidThomas Moeslinger
Feb 19, 2013·Diabetic Medicine : a Journal of the British Diabetic Association·A G Jones, A T Hattersley
Aug 14, 2002·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·David S H Bell, Fernando Ovalle
Jul 15, 2004·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·D S Bell, M S Mayo
Mar 10, 2001·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·D S Bell, F Ovalle
Jul 15, 2004·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·D S Bell, F Ovalle
Aug 18, 2004·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·David S H Bell

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