Effect of combination therapy of a rapid-acting insulin secretagogue (glinide) with premixed insulin in type 2 diabetes mellitus.
OBJECTIVE
The effect of rapid-acting insulin secretagogues (glinides) on glycemic control when included with insulin therapy for type 2 diabetes remains uncertain. To examine this, we added glinide once a day to twice daily injections of premixed insulin.


METHODS
Seventy-four type 2 diabetic patients, taking twice daily injections of premixed insulin and whose diabetic control was stable, were registered at 6 independent institutions. After a 3-month observation period, 60 patients were administered 10 mg mitiglinide or 90 mg nateglinide at lunchtime without changing their insulin regimen. After 12 weeks, administration of glinide was discontinued and observation was continued. HbA1c levels were measured at the start of glinide administration, after 12 weeks of glinide , and at 12 weeks after discontinuation.


RESULTS
HbA1c improved from 7.72+/-0.66% to 7.55+/-0.71% (p <0.01) at Week 12 of glinide administration. Twelve weeks after discontinuation, HbA1c returned to the baseline level (7.72+/-0.81%).


CONCLUSIONS
This study indicates that the addition of glinide once a day at lunchtime to twice daily injections of premixed insulin is effective for the treatment of type 2 diabetes.
Department of Internal Medicine, Kitasato Institute Hospital, Tokyo. yamada-s@kitasato.or.jp
Satoru
S
Yamada
Mari
M
Watanabe
Osamu
O
Funae
Yoshihito
Y
Atsumi
Ryuji
R
Suzuki
Ken
K
Yajima
Yoshiko
Y
Nakamura
Toshihide
T
Kawai
Yoichi
Y
Oikawa
Akira
A
Shimada
D000368:Aged; D001786:Blood Glucose / Q000187:drug effects; D003510:Cyclohexanes / Q000008:administration & dosage*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D054833:Isoindoles / Q000008:administration & dosage*; D007564:Japan; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D000077715:Nateglinide; D010649:Phenylalanine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome
D001786:Blood Glucose; D003510:Cyclohexanes; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D054833:Isoindoles; D000077715:Nateglinide; D010649:Phenylalanine; C087255:mitiglinide