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The British Journal of Diabetes & Vascular Disease
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Review: Combination treatment with insulin and oral agents in type 2 diabetes mellitus

John Burke

Thames House, Barnet General Hospital, Wellhouse Lane, Barnet Hertfordshire, EN5 3DJ, UK, john.burke{at}barnet-chase-tr.nhs.uk

The need to improve glycaemic control in type 2 diabetes has been reinforced by the United Kingdom Prospective Diabetes Study (UKPDS). Due to progressive deterioration of beta-cell function after diagnosis, oral hypoglycaemic agents often fail to maintain adequate glycaemic control after only a few years of treatment. This paper considers the treatment options available at this stage and reassures diabetologists that the combined use of insulin plus metformin with or without an added sulphonylurea is logical, is as effective as insulin alone, and provides superior weight regulation in many patients. A. combination of metformin with glargine insulin seems particularly effective and well tolerated. The long-term advantages of such treatments in terms of clinical outcomes have yet to be demonstrated in clinical trials.

Key Words: insulin • oral antidiabetic agent • type 2 diabetes • metformin • sulphonylurea • thiazolidinedione • combination therapy.

References

  • The diabetes control and complications trial research group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977-86.[Abstract/Free Full Text]
  • UK Prospective diabetes study (UKPDS) group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Burke BJ, Hartog M., Waterfield MR Improved diabetic control in insulin-dependent diabetics treated with insulin and glibenclamide. Acta Endocrinol 1984;107:70-7.[Medline] [Order article via Infotrieve]
  • Chehade JM, Mooradian AD A rational approach to drug therapy of type 2 diabetes mellitus. Drugs 2000;60:95-113.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Hermann LS Optimising therapy for insulin-treated type 2 diabetes mellitus. Drugs & Ageing 2000;17:283-94.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • University Group Diabetes Program. A study of the effects of hypoglycaemic agents on vascular complications in patients with adult-onset diabetes. Diabetes 1976;25:1129-53.[Web of Science][Medline] [Order article via Infotrieve]
  • Buse J. Combining insulin and oral agents. Am J Med 2000:108(6A):24S-32S.
  • UK Prospective diabetes study (UKPDS) group. Overview of 6 years' therapy of type ll diabetes (UKPDS 16). Diabetes 1995;44:1249-58.[Abstract]
  • Stumvoll M., Nurjhan N., Perriello G. et al. Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. N Engl J Med 1995;333:550-4.[Abstract/Free Full Text]
  • UK Prospective diabetes study (UKPDS) group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998;352:854-65.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • National Institute for Clinical Excellence (NICE). Technology appraisal guidance No. 63, 2003.
  • Dunn NR, Bough P. Standards of care of diabetic patients in a typical English community. Br J Gen Pract 1996;46:401-05.[Web of Science][Medline] [Order article via Infotrieve]
  • Meigs JB, Singer DE, Sullivan LM et al. Metabolic control and prevalent cardiovascular disease in non-insulin-dependent diabetes mellitus (NIDDM): The NIDDM patient outcome research team. Am J Med 1997; 102:38-47.[Web of Science][Medline] [Order article via Infotrieve]
  • European Diabetes Policy Group 1999. A desktop guide to type 2 diabetes mellitus. Diabet Med 1999;16:716-30.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Yki-Järvinen H., Kauppila M., Kujansuu E. et al. Comparison of insulin regimens in patients with non-insulin-dependent diabetes mellitus. N Eng J Med 1992;327:1426-33.[Abstract]
  • Yki-Järvinen H. Combination therapies with insulin in type 2 diabetes. Diabetes Care 2001;24:758-67.[Free Full Text]
  • Delea TE, Edelsberg JS, Hagiwara M., Oster G., Phillips LS Use of thiazolidinediones and risk of heart failure in people with type 2 diabetes: a retrospective cohort study. Diabetes Care 2003;26:2983-9.[Abstract/Free Full Text]
  • Holman RR, Turner RC A practical guide to basal and prandial insulin therapy. Diabet Med 1985;2:45-53.[Medline] [Order article via Infotrieve]
  • Yki-Järvinen H., Ryysy L., Nikkilä K. et al. Comparison of bedtime insulin regimens in patients with type 2 diabetes mellitus. Ann Int Med 1999; 130:389-96.[Abstract/Free Full Text]
  • Robinson AC, Burke J., Robinson S. et al. The effects of metformin on glycaemic control and serum lipids in insulin-treated NDDM patients with suboptimal metabolic control. Diabetes Care 1998;21:701-05.[Abstract]
  • Després JP Potential contribution of metformin to the management of cardiovascular disease risk in patients with abdominal obesity, the metabolic syndrome and type 2 diabetes. Diabetes Metab 2003;29:6S53-61.[Medline] [Order article via Infotrieve]
  • Furlong NJ, Hulme SA, O'Brien SV et al. Repaglinide versus metformin in combination with bedtime NPH insulin in patients with type 2 diabetes established on insulin/metformin combination treatment. Diabetes Care 2002;25:1685-90.[Abstract/Free Full Text]
  • Mäkimattila S., Nikkilä K., Yki-Järvinen H. Causes of weight gain during insulin therapy with and without metformin in patients with type II diabetes mellitus. Diabetologia 1999;42:406-12.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Strowig SM, Aviles-Santa ML, Raskin P. Comparison of insulin monotherapy and combination therapy with insulin and metformin or insulin and troglitazone in type 2 diabetes. Diabetes Care 2002;25:1691-8.[Abstract/Free Full Text]
  • Poulsen MK, Henriksen JE, Hother-Nielsen O., Beck-Nielsen H. The combined effect of triple therapy with rosiglitazone, metformin and insulin aspart in type 2 diabetic patients. Diabetes Care 2003;26:3273-9.[Abstract/Free Full Text]
  • Furlong NJ, Hulme SA, O'Brien SV et al. Comparison of repaglinide vs. gliclazide in combination with bedtime NPH insulin in patients with type 2 diabetes inadequately controlled with oral hypoglycaemic agents. Diabet Med 2003;20:935-41.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kelly DE, Bidot P., Freedman Z. et al. Efficay and safety of acarbose in insulin-treated patients with type 2 diabetes. Diabetes Care 1998;21: 2056-61.[Abstract]
  • Riddle MC, Schneider J. Beginning insulin treatment of obese patients with evening 70/30 insulin plus glimepiride versus insulin alone. Diabetes Care 1998;21:1052-7.[Abstract]
  • Yki-Järvinen H., Dressler A., Ziemen M. Less nocturnal hypoglycaemia and better post-dinner glucose control with bedtime insulin glargine compared with bedtime NPH insulin during insulin combination therapy in type 2 diabetes. Diabetes Care 2000;23:1130-6.[Abstract/Free Full Text]
  • Standl E., Maxeiner S., Schweitzer MA, HOE901/4009 study group. Morning versus bedtime insulin glargine in combination with glimeperide: No difference in incidence of nocturnal hypoglycaemia in patients with type 2 diabetes. Diabetes 2003;52(suppl 1):A134.
  • Riddle MC, Rosenstock J., Gerich J. The treat-to-target trial: randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients. Diabetes Care 2003;26:3080-6.[Abstract/Free Full Text]
  • The DECODE study group on behalf of the European Diabetes Epidemiology Group. Glucose tolerance and mortality: comparison of WHO and American diabetes association diagnostic criteria. Lancet 1999;354:617-21.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Ceriello A. The post-prandial state and cardiovascular disease: relevance to diabetes mellitus. Diabetes Metab Res Rev 2000;16:125-32.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Burke J., Burke L., Andrews C. Continuous glucose monitoring in type 2 diabetes and the relationship between post-prandial hyperglycaemia and glycated haemoglobin. Diabetologia 2003;46(suppl 2):A240.
  • Department of Health. National service framework for diabetes: Standards. London: Department of Health, 2003.

The British Journal of Diabetes & Vascular Disease, Vol. 4, No. 2, 71-76 (2004)
DOI: 10.1177/14746514040040020201


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This Article
Right arrow Abstract Freely available
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Right arrow Alert me when this article is cited
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Right arrow Articles by Burke, J.
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What's this?