evalu ation of insulin-sul fonylurea combination v ersijs insulin al one in the t reatment of non-insulin d ependent diabetes mellitu s (nid dm)

lowering the glucose level in diabetic patients reduces the risk of many consequences which are usually reported in these patients. non-insulin dependent (type ii) diabetes which cannot be controlled with sulfonylureas alone can be controlled with a combination of sulfonylurea and insulin. in an open randomized trial 58 patients were divided into three groups. the first group received only insulin based on their blood glucose level. the second group received a set amount of insulin plus the required amount of glibenclamide and the third group received a set amount of insulin plus the required amount of chlorpropamide based on their glycemic control. all three groups had a significant reduction of blood glucose, total cholesterol and triglyceride levels. the best long term glycemic control was in the second group with the lowest hbalc(% ). in these patients bedtime insulin and daytime sulfonylurea (b ids) gives better glycemic control. this method of therapy is a valuable option for patients with niddm whose hyperglycemia cannot be controlled by sulfonylureas and do not have compliance with more than one injection a day.