Response of regimens of insulin therapy in type 2 diabetes mellitus subjects with secondary failure.

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dc.contributor.authorZargar, A Hen_US
dc.contributor.authorMasoodi, S Ren_US
dc.contributor.authorLaway, B Aen_US
dc.contributor.authorWani, A Ien_US
dc.contributor.authorBashir, M Ien_US
dc.date.accessioned2002-05-21en_US
dc.date.accessioned2009-05-31T00:30:36Z
dc.date.available2002-05-21en_US
dc.date.available2009-05-31T00:30:36Z
dc.date.issued2002-05-21en_US
dc.description.abstractOBJECTIVE: To find the response of various regimen of combination therapy (Insulin and Glibenclamide) in type 2 diabetes mellitus subjects who failed to respond to maximum doses of glibenclamide (GBC) plus phenformin. METHODS: A total of 188 subjects with secondary sulfonylurea failure who failed to respond to maximum doses of GBC and phenformin were randomised to receive one of the four regimens. Group A (50 patients) received two doses of insulin; Group B (49 patients) received two doses of insulin and GBC 20 mg/day; Group C (43 patients) received morning dose of insulin with GBC 20 mg/day; and Group D (46 patients) received evening dose of insulin with GBC 20 mg/day. Insulin dose was adjusted to achieve an acceptable blood glucose control. Control of diabetes was revaluated at three months post-treatment period. RESULTS: Age, duration of diabetes, weight, body mass index (BMI) and biochemical parameters were comparable in all four groups at admission. Dose of insulin was 0.83 +/- 0.07, 0.86 +/- 0.06, 0.46 +/- 0.04 and 0.39 +/- 0.03 units/Kg/day in groups A, B, C and D, respectively. Comparing groups A and B, we found that the dose of insulin (IU/kg/day) required to achieve acceptable fasting blood glucose (FBG) did not differ significantly. Similarly, comparison between Groups C and D did not reveal any significant difference in insulin dose. Mean hospital stay required to achieve an acceptable FBG was 8.42 +/- 0.34, 11.95 +/- 1.11, 8.59 +/- 0.61 and 7.10 +/- 0.48 days in groups A, B, C and D, respectively (p = 0.013). On comparing the four treatment regimens, at three months follow-up, there was a significant increase in bodyweight in Group C; also there was an increase in fasting blood glucose in all the groups except in Group D. CONCLUSIONS: Continuation of GBC in type 2 diabetes mellitus subjects who fail to respond to maximum doses of GBC plus phenformin and who need two doses of insulin for control has no added advantage over giving insulin alone. In subjects controlled on a single dose of insulin with glibenclamide it is preferable to give an evening dose rather than a morning dose.en_US
dc.description.affiliationDepartment of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.en_US
dc.identifier.citationZargar AH, Masoodi SR, Laway BA, Wani AI, Bashir MI. Response of regimens of insulin therapy in type 2 diabetes mellitus subjects with secondary failure. Journal of the Association of Physicians of India. 2002 May; 50(5): 641-6en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/91369
dc.language.isoengen_US
dc.source.urihttps://www.japi.orgen_US
dc.subject.meshBlood Glucoseen_US
dc.subject.meshBody Mass Indexen_US
dc.subject.meshDiabetes Mellitus, Type 2 --blooden_US
dc.subject.meshDrug Administration Scheduleen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshFemaleen_US
dc.subject.meshGlyburide --administration & dosageen_US
dc.subject.meshHumansen_US
dc.subject.meshHypoglycemic Agents --administration & dosageen_US
dc.subject.meshInsulin --administration & dosageen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPostprandial Perioden_US
dc.subject.meshTreatment Failureen_US
dc.titleResponse of regimens of insulin therapy in type 2 diabetes mellitus subjects with secondary failure.en_US
dc.typeClinical Trialen_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
dc.typeRandomized Controlled Trialen_US
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