Combined insulin-glibenclamide therapy of NIDDM patients in primary health care. A follow-up study of its compliance and efficacy and a review of the literature.
Twenty non-insulin-dependent diabetic (NIDDM) patients with secondary failure to sulphonylureas were given combined insulin-glibenclamide therapy. After discharge they were followed for the following 12 months at different primary care centres. In the 19 patients who completed the combined therapy, the mean glycosylated haemoglobin A1c (HbA1c) level decreased from 11.2 +/- 0.5% to 9.1 +/- 0.3% at 2 months (p less than 0.001), and remained at 9.1 +/- 0.4% at 12 months. The reduction of HbA1c was positively correlated with the HbA1c value and inversely with the initial body weight (both p less than 0.05). There was a slight rise in the body mass index (BMI) from 26.9 +/- 0.9 to 28.2 +/- 0.7 at 12 months (p less than 0.001), which was inversely correlated with the BMI value at 0 month (p less than 0.05). The insulin doses were similar at 2 and 12 months. A review of the literature since 1985 identified ten double-blind, controlled studies on combined insulin-sulphonylurea therapy, comprising 156 NIDDM patients followed for 8-52 weeks. Improved glycaemic control and endogenous insulin secretion were documented in nine of these studies in parallel with a decrease of insulin requirement in six studies. We conclude from our own experience and the literature that combined insulin-glibenclamide therapy is an efficient and compliant therapeutic regimen.
Liu
D
D
Department of Medicine, Danderyd Hospital, Stockholm, Sweden.
Wettergren
M
M
Lins
P E
PE
Adamson
U
U
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005905:Glyburide / Q000627:therapeutic use*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011320:Primary Health Care; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D013548:Sweden
D001786:Blood Glucose; D005905:Glyburide; D006442:Glycated Hemoglobin; D007328:Insulin; D013453:Sulfonylurea Compounds