Efficacy of Sulfonylureas Plus α-Glucosidase Inhibitor Plus Bedtime NPH Insulin Combination Therapy in Type II Diabetic Patients with Secondary Failure Using Sulfonylureas

Abstract

The effect of long term therapy over 6 months in type II diabetic patients with secondary failure using surfonylureas was evaluated by comparing morning NPH insulin alone (mono-therapy group)(n=19) with surfonylureas plusα-glucosidase plus bedtime NPH insulin (combination therapy group)(n=17). Glycemic control improved in both groups ; however, there was no difference in HbAic level between the two groups (7.7±1.2% in the mono-therapy group vs. 7.2±0.8% in the combination therapy group).
Six months after discharge, total insulin dosage was significantly less in the combination therapy group compared with the mono-therapy group (5.2±2.4U vs. 21.1±4.9U, p<0.01). At the same time, weight gain was also suppressed more significantly in the combination therapy group than in the mono-therapy group.(0.5±2.2 kg vs. 2.5±3.0 kg, p<0.01).
Combination therapy was effective in achieving a normal FPG level without causing excessive or severe hypo-glycemia and could achieve similar glycemic control without weight gain, with smaller doses of insulin than with mono-therapy.
We conclude that combination therapy merits consideration as a therapeutic strategy in patients with secondary failure using sulfonylureas.