COMBINATION USE OF SULFONYLUREAS AND INSULIN IN THE TREATMENT OF NONINSULIN-DEPENDENT DIABETES-MELLITUS

Combination therapy with insulin and sulfonylureas for treatment of noninsulin-dependent diabetes mellitus has been evaluated frequently. However, many of the trials either lacked proper control or were of inadequate duration, and none compared combination therapy to intensive insulin therapy using several daily injections. Such a combination decreases, but does not return to normal, glycosylated hemoglobin and fasting glucose concentrations in comparison to therapy with one or two dally injections of insulin in some subjects. Alternatively, adding a sulfonylurea to insulin therapy may allow a reduction in the insulin dosage without compromising glycemic control. When considering the use of the two agents, the possible advantage of a simplified insulin regimen must be weighed against the disadvantages of an increased potential for adverse effects and increased cost.