22283
document
Combined therapy for obese type 2 diabetes : suppertime mixed insulin with daytime sulfonylurea . Combined insulin and sulfonylurea therapy for type 2 diabetes may improve the effectiveness of a single injection of insulin , thereby postponing the need for multiple injections . This concept was tested in 21 obese subjects imperfectly controlled by 20 mg of glyburide daily in a double masked , placebo-controlled , parallel design , 16-week protocol . Premixed 70 % NPH/30 % Regular insulin was taken before supper , and the dosage was adjusted weekly by an algorithm seeking nearly normal fasting glycemia . Eleven subjects using insulin plus 10 mg glyburide before breakfast had lower mean fasting glucose at 10-16 weeks than 10 subjects using insulin with placebo ( mean +/- SEM ; 5.9 +/- 0.3 versus 7.5 +/- 0.7 mmol/L ; p less than 0.05 ) , and had a greater decrement of glycosylated hemoglobin from baseline values ( 1.3 +/- 0.1 versus 0.8 +/- 0.2 % A1 , p less than 0.05 ) . After 16 weeks the combined therapy group used half as much insulin as the insulin-only group ( 50 +/- 5 versus 101 +/- 13 units/d ; p less than 0.01 ) . Fasting serum free insulin values increased 58 % from baseline after insulin therapy in the insulin-only group ( p less than 0.05 ) but did not increase with combined therapy . Weight gain was similar in the two groups . These data support this form of combined therapy as one option for treating obese persons with type 2 diabetes no longer responsive to oral therapy alone .
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Intervention_Pharmacological
suppertime mixed insulin with daytime sulfonylurea
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Intervention_Pharmacological
Combined insulin
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Intervention_Pharmacological
sulfonylurea therapy
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Intervention_Pharmacological
injection of insulin
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Intervention_Pharmacological
20 mg of glyburide daily
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
Regular insulin
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Intervention_Pharmacological
insulin plus
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Intervention_Pharmacological
glyburide
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Intervention_Control
placebo
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Outcome_Physical
obese type 2 diabetes
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Outcome_Physical
type 2 diabetes
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Outcome_Other
effectiveness
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Outcome_Physical
glycosylated hemoglobin
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Outcome_Physical
Fasting serum free insulin values
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Outcome_Physical
Weight gain
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Participant_Condition
type 2 diabetes
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Participant_Sample-size
21
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Participant_Sample-size
Eleven
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Participant_Condition
type 2 diabetes