title: [The effects of insulin combined with glibenclamide on glucose and lipid metabolism in patients with Type II diabetes mellitus].
abstract: We compared the effects of twice-daily insulin injections (n = 22) with combined insulin-glibenclamide therapy (n = 25) on glucose and lipid metabolism in 47 type II diabetic patients (age 69 (SD 9) years, BMI 25.5 (4.8) kg/m2, diabetes duration 9 (range 1-34) years) with secondary failure to sulphonylurea. After 6 months, weight gain averaged 4.2 kg (p less than 0.05), fasting blood glucose had decreased from 14.6 to 8.5 mmol/l (p less than 0.001), HbA1c from 10.9% to 8.1% (p less than 0.001). Twenty-one patients reached HbA1c levels less than 8.0%. Patients on insulin alone injected more insulin (42 vs 26 U daily, p less than 0.01). The decrease of fasting blood glucose and HbA1c was comparable in both groups (p less than 0.001). HDL-cholesterol increased (insulin: 1.10 to 1.24 mmol/l, combined therapy: 1.03 to 1.14 mmol/l, both p less than 0.01), while plasma triglycerides and NEFA decreased (p less than 0.01). Only in patients on insulin alone did total cholesterol decrease from 7.1 to 6.3 mmol/l (p less than 0.001), and LDL-cholesterol from 4.7 to 4.1 mmol/l (p less than 0.05). Apolipoproteins AI, AII and B did not show significant changes. Almost all patients reported improved wellbeing; no severe hypoglycaemias were observed.
authors.affiliation: Academisch Ziekenhuis, afd. Inwendige Geneeskunde, werkgroep Endocrinologie, Maastricht.
authors.forename: B H
authors.initials: BH
authors.lastname: Wolffenbuttel
authors.forename: G J
authors.initials: GJ
authors.lastname: Rondas-Colbers
authors.forename: P P
authors.initials: PP
authors.lastname: Menheere
authors.forename: J P
authors.initials: JP
authors.lastname: Sels
authors.forename: A C
authors.initials: AC
authors.lastname: Nieuwenhuijzen Kruseman
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism*; D005905:Glyburide / Q000008:administration & dosage / Q000627:therapeutic use*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D050356:Lipid Metabolism; D008297:Male; D010353:Patient Education as Topic; D012648:Self Care
chemical_list: D005947:Glucose; D005905:Glyburide; D006442:Glycated Hemoglobin; D007328:Insulin
vernacular_title: De effecten van insuline in combinatie met glibenclamide op glucose- en vetstofwisseling bij patiënten met diabetes mellitus type II.