COMBINING INSULIN AND SULFONYLUREA - A THERAPEUTIC OPTION FOR TYPE-II DIABETES

Combining sulfonylurea with an evening injection of insulin enjoys growing acceptance in the diabetes community and offers another therapeutic option when oral agents are no longer effective in patients with type II diabetes. We believe that combined therapy offers the simplest means to achieve good glycemic control in many patients at a particular stage of the disease. Selection of the right patient at the right time is critical to success. Properly used, this approach seems both safe and well accepted by patients. When new oral therapies acting by different mechanisms than sulfonylureas become available in this country, other forms of combined therapy will come into use. Specifically, metformin, a biguanide that is widely used in other parts of the world, is likely to be helpful for some patients who are approaching the time of sulfonylurea failure and may extend the duration of successful oral therapy. Combined therapy with a sulfonylurea, insulin, and metformin may also prove useful for some patients. Physicians thus can look forward to even more therapeutic options for type II diabetes in the future.