Combination therapy in NIDDM

Article Abstract:

Many physicians are interested in the use of oral hypoglycemic drugs and insulin to treat patients with non-insulin dependent diabetes mellitus (NIDDM) who do not respond to treatment with oral hypoglycemic drugs alone. Patients with NIDDM have both decreased levels of insulin and decreased sensitivity to insulin in the liver. Insulin is a hormone secreted by the pancreas that promotes the metabolism of glucose (sugar). Combination therapy provides treatment for both insulin deficiency and insulin resistance, but some physicians rarely recommend this type of treatment. A research study found that treatment with oral hypoglycemic drugs and insulin was more effective than oral hypoglycemic drugs alone for achieving hypoglycemic control in patients with NIDDM. Patients who received one injection of insulin in the evening had less weight gain and were less likely to develop hyperinsulinemia, or increased blood levels of insulin, than the other patients. The main advantage of this treatment over treatment with insulin alone is the reduced risk of hyperinsulinemia.

Editorial

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Comparison of insulin regimens in patients with non-insulin-dependent diabetes mellitus

Article Abstract:

One injection of NPH insulin in the evening in combination with oral hypoglycemic drugs may be more effective and safe than other insulin treatment regimens for patients with non-insulin-dependent diabetes mellitus (NIDDM). Among 153 patients with NIDDM, 28 were treated with oral hypoglycemic drugs and one injection of NPH insulin in the evening, 32 with oral hypoglycemic drugs and one injection of NPH insulin in the morning, 29 with two injections per day of NPH and regular insulin, 30 with an injection of NPH insulin in the morning and regular insulin before meals and 30 with oral hypoglycemic drugs alone. The improvement in hypoglycemic control was significantly greater in patients treated with insulin than for those treated with oral hypoglycemic drugs alone. Patients treated with one injection of insulin in the evening were less likely to gain weight or to suffer from increased blood levels of insulin than those who were treated with the other insulin regimens.

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Effect of troglitazone in insulin-treated patients with type II diabetes mellitus

Article Abstract:

The antidiabetic drug troglitazone appears to be successful in lowering blood sugar levels when taken in addition to insulin. Researchers evaluated the drug in 314 patients with non-insulin-dependent, or type 2, diabetes. All of the patients had poorly controlled blood sugar levels despite taking insulin. The drug reduced blood sugar levels even though the insulin dose was reduced to prevent hypoglycemia. Troglitazone caused a slight increase in blood cholesterol levels.

Evaluation, Troglitazone

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