Abstract
We investigated the effect of combination therapy with preprandial rapid-acting insulin injections and α-glucosidase inhibitor (α-GI), which is known to suppress postprandial hyperglycemia, on discontinuation of insulin treatment in non-obese NIDDM patients with secondary failure on oral hypoglycemic agents.
Thirty-six hospitalized patients (17 male and 19 female) with NIDDM who showed poor glycemic control during 2 weeks of diet and exercise therapy with almost maximal doses of sulfonylureas were divided into a group treated with rapid-acting insulin injection plus α-GI before each meal (group I; n=17), and a group treated with rapid-acting insulin inlection alone (group II; n=19)
There were no significant differences in daily insulin requirements, fasting plasma glucose, HBA1c or serum fructosamine between groups I and II. However, both meal-related and premeal glycemia was normalized in group I and the period of insulin treatment was 12.7 days shorter than in group II. Urinary CPR excretion levels were markedly lower during insulin therapy than before treatment, and systolic blood pressure also decreased significantly. Insulin therapy did not induce weight gain or increase serum lipid levels, and the incidence of hyperglycemia in group I was lower than in group II.
These observations indicate that combination therapy with preprandial rapid-acting insulin injections and α-GI can shorten the period of insulin therapy and facilitate discontinuation of insulin treatment through normalization of postprandial hyperglycemia as well as the resting state of pancreatic beta cells in NIDDM patients with secondary failure on oral hypoglycemic agents.
