title: Insulin-metformin combination therapy in obese patients with type 2 diabetes.
abstract: The aim of the study was to evaluate the effects of insulin-metformin combination therapy compared to insulin monotherapyin obese, insulin-requiring patients with type 2 diabetes mellitus. Eighteen patients uncontrolled on > or = 70 U/day of insulin monotherapy were investigated in this prospective, open-label study. Patients continued their previous insulin and dietary regimens for 4 weeks, after which metformin was added with doses titrated to achieve a fasting plasma glucose (FPG) < 7.8 mmol/l or until the maximum daily dose was reached. Insulin-metformin combination therapy was continued for an additional 8 weeks. Insulin-metformin combination therapy resulted in a significant decrease in glycated hemoglobin values with a final mean reduction of 1.5% +/- 1.2% (p = 0.001). FPG decreased significantly (p < 0.005) by week 4 of insulin-metformin therapy, but the change was not statistically significant by week 12, and daily insulin requirements were significantly reduced during combination therapy (p < 0.05). These results suggest that in obese patients with type 2 diabetes mellitus receiving > or = 70 U of daily insulin, the addition of metformin leads to improved glycemic control with lower daily doses of insulin and without adverse effects.
authors.affiliation: Wayne State University, Detroit, Michigan 48201, USA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Jaber
authors.forename: Sandra N
authors.initials: SN
authors.lastname: Nowak
authors.forename: Richard R
authors.initials: RR
authors.lastname: Slaughter
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D009765:Obesity; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin