TRAITEMENT COMBINE PAR LE GLIBENCLAMIDE ET L'INSULINE ULTRALENTE DANS L'ECHEC SECONDAIRE AUX SULFONYLUREES CHEZ LES PATIENTS DE POIDS NORMAL, SUIVI A DEUX ANS

A. E. Pontiroli, G. Dino, F. Capra, G. Pozza

Research output: Contribution to journalArticlepeer-review

Abstract

Nine lean diabetic patients with secondary failure of oral hypoglycemic agents and with a poor residual insulin release under treatment with glibenclamide (15 mg/day) entered a cross-over study, in which ultralente insulin was administered alone or in combination with glibenclamide (15 mg/day). Combined therapy was accompanied by increased serum free-insulin levels and was more effective than glibenclamide alone on daily blood glucose profile, on glycosylated haemoglobin (HbA1C) and on Beta-OH butyrate; in 6 patients a near normalization of blood glucose control (daily blood glucose levels <180 mg/dl) occurred. C peptide release, evaluated as daily profile and as response to i.v. glucagon, did not significantly change. When patients received insulin alone, daily blood glucose profile and HbA1C worsened, and serum free-insulin levels and C peptide release decreased, while Beta-OH butyrate levels remained low. These data indicate that combined therapy is effective since it maintains insulin release and enhances free insulin levels in insulinopenic patients. Four responders continued combined therapy for 2 years: the treatment was still effective and was accompanied by an increased C peptide release, probably due to persistent euglycemia.

Original languageEnglish
Pages (from-to)323-327
Number of pages5
JournalDiabete et Metabolisme
Volume16
Issue number4
Publication statusPublished - 1990

Keywords

  • C peptide
  • Glibenclamide
  • Glycosylated hemoglobin
  • Insulin
  • Insulin islet cell antibodies (ICA)
  • NIDDM
  • Oral hypoglycemic agents
  • Secondary failure
  • Ultralente

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

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