[Value of combined subcutaneous infusion of insulin and metformin in 10 insulin-dependent obese diabetics].
Combined continuous subcutaneous insulin infusion (CSII) and metformin (M) was tested in 10 overweighted insulin requiring diabetic patients (body mass index 27.9 +/- 4.9 kg/m2). They were still poorly controlled (HbA1 9.6 +/- 0.8%) despite large doses of lente insulin (Novo) (51.7 +/- 19.6 IU/24 h) injected once daily. With CSII after two weeks on placebo (P) they were enrolled in a randomized double blind cross-over trial with two successive one month periods of M (2550 mg/day) or P. At the end of the two-weeks period CSII--initial P, the daily regular insulin requirement decreased significantly (40.1 +/- 18.1). During M and P body weight and HbA1 were unchanged (respectively 28.6 +/- 6.0 vs 29.0 +/- 59 kg/m2 and 7.7 +/- 1.1 vs 7.7 +/- 0.8%). With M daily insulin requirements decreased significantly (32.0 +/- 16.8 vs 38.4 +/- 18.2 IU, p less than 0.05). During test-meals, M compared to placebo also reduced peripheral free insulin concentrations (-24.9 +/- 26.0%) while plasma glucose and C peptide remained comparable. In the conditions of this study, combined CSII and M reduced the insulin resistance observed in overweighted insulin requiring diabetic patients.
Leblanc
H
H
Service d'Endocrinologie-Diabétologie, Hôpital Saint Louis, Paris.
Marre
M
M
Billault
B
B
Passa
P
P
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002986:Clinical Trials as Topic; D003920:Diabetes Mellitus; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007333:Insulin Resistance; D008297:Male; D008687:Metformin / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity; D010455:Peptides / Q000097:blood; D011897:Random Allocation
D001786:Blood Glucose; D007328:Insulin; D010455:Peptides; C050632:polypeptide C; D008687:Metformin
Intérêt de l'association infusion sous-cutanée d'insuline et metformine chez 10 diabétiques insulino-nécessitants obèses.