Abstract
We have evaluated the long-term (18 months) effectiveness of the addition of once-daily insulin glargine (bedtime or morning) in the treatment of 44 type 2 diabetic patients (male/female: 27/17, mean HbA1c: 9.7±1.6%) who had taken the maximum or a semi-maximum dose of sulfonylurea for more than a year but had not shown reduction of the HbA1c to below 7.5%.
After 6 months, we divided the patients into two groups; improved group, in which the HbA1c decreased to below 7.0% (n=11, mean HbA1c: 6.7±0.3%), and the no-improvement group, in which sustained elevation of HbA1c at over 7.0% (n=16, mean HbA1c: 8.3±1.2%) was observed.
In the improved group, the mean HbA1c after 18 months was still below 7.0% (6.9±0.6%; p<0.001) and the dose of insulin glargine had not increased significantly. On the other hand, in the no-improvement group, no further improvement of the HbA1c value was observed between 6 and 18 months (8.3±1.3%) despite the significant increase in the dose of insulin glargine (9.3±4.8U⇒14.3±7.1U).
These results suggest that this novel combination therapy shows long-term effectiveness, and may be recommended as a treatment of first-choice for patients who have difficulty in accepting intensive insulin therapy.
