Addition of Sulfonylurea to Insulin Treatment in Poorly Controlled Type II Diabetes: Title and subTitle BreakA Double-blind, Randomized Clinical Trial FREE

David S. Schade, MD; William J. Mitchell, MD; Ganera Griego, RN, CFNP

[+] Author Affiliations

Reprint requests to Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131 (Dr Schade).

JAMA. 1987;257(18):2441-2445. doi:10.1001/jama.1987.03390180059023

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ABSTRACT

ABSTRACT | REFERENCES

This study examined the potential beneficial effects of the addition of a secondgeneration sulfonylurea to insulin therapy for poorly controlled type II diabetes. A randomized, double-blind, crossover experimental design was utilized in 16 type II diabetic patients for a period of eight months. Treatment with glyburide, 20 mg/d (plus insulin), compared with placebo (plus insulin) resulted in a significant reduction in mean basal glucose (232 ± 12 vs 262 ±11 mg/dL [12.8 vs 14.4 mmol/L]) and hemoglobin A_1c (10.2% ±0.5% vs 10.9% ±03%) concentrations. Concomitant with this change, basal C-peptide and free insulin values increased with glyburide therapy, but this pharmacological agent did not alter the ability of the patient's erythrocytes to bind insulin. We conclude that in type II diabetic subjects receiving more than 28 units of insulin per day, the addition of glyburide results in a marginal, but statistically significant improvement in basal glucose concentration, but not in glucose tolerance as assessed by integrated glucose concentration. Whether this small improvement in glycemia is worth the additional cost of sulfonylureas or the risk of drug side effects is not known.

(JAMA 1987;257:2441-2445)

REFERENCES

ABSTRACT | REFERENCES

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