Abstract
The effects of combination therapy with insulin and sulfonylurea on glycemic control were investigated. Fifteen patients with type II diabetes mellitus who did not obtain sufficient glycemic control with sulfonylurea were studied. They were admitted to our hospital and were first treated with insulin alone. Two weeks later, glibenclamide therapy was added to the insulin therapy. Fasting plasma glucose (FPG), FibA1c and urinary glucose levels were measured as paramoters of glycemic control. Daily urinary secretion of c-peptide was also measured as a marker of endogenous insulin secretion. M value was determined from the data on blood glucose of diurnal variance as a parameter of fluctuation of blood glucose levels.
The mean levels of FPG, HbA1c and urinary glucose were all significantly decreased during 2 weeks of combination therapy. The mean M value was also significantly decreased in this period. The decrease in M value seems to be caused by the improvement of glycemic control in terms of less fluctuation of blood glucose levels, which might be due to an increase in endogenous insulin secretion induced by sulfonylurea.
The combination therapy may be advantageous in glycemic control for patients with type II diabetes mellitus with sulfonylurea drug failure whose endogenous insulin secretion is reserved.
