 |
|
 |
- March 10, 2010 |
|
|
Welcome to the #1 online source of information for Diabetes Specialists! An international online community of more than 10,000 Diabetes Specialists.
CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
|
|
|
| Presentation |
|
"Use of Combination Therapy in the Treatment of Type 2 Diabetes"Dr. Amir Hanna (biography)
English - 2002-01-19 - 22 minutes
|
 | (35 slides) |
Summary :
The initiation of intensive treatment at the beginning of the disease provides superior results for the control of glucose levels and the development of complications, contrary to presently accepted guidelines.
Learning objectives :
LEARNING OBJECTIVES:
Upon completion of this presentation, participants should be able to:
1. Review the impact of intensive and early glucose control on the
complications of diabetes.
2. Understand the characteristics of different classes of hypoglycemic
agents.
3. Provide an overview of recent combination therapy studies.
Bibliographic references :
Comparison of insulin monotherapy and combination therapy with insulin and metformin or insulin and troglitazone in type 2 diabetes.
Strowig SM, Aviles-Santa ML, Raskin P.
University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
OBJECTIVE-To evaluate the safety and efficacy of treatment with insulin alone, insulin plus metformin, or insulin plus troglitazone in individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS-A total of 88 type 2 diabetic subjects using insulin monotherapy (baseline HbA(lc) 8.7%) were randomly assigned to insulin alone (n = 31), insulin plus metformin (n = 27), or insulin plus troglitazone (n = 30) for 4 months. The insulin dose was increased only in the insulin group. Metformin was titrated to a maximum dose of 2,000 mg and troglitazone to 600 mg.
RESULTS-HbA(lc) levels decreased in all groups, the lowest level occurring in the insulin plus troglitazone group (insulin alone to 7.0%, insulin plus metformin to 7.1%, and insulin plus troglitazone to 6.4%, P < 0.0001). The dose of insulin increased by 55 units/day in the insulin alone group (P < 0.0001) and decreased by 1.4 units/day in the insulin plus metformin group and 12.8 units/day in the insulin plus troglitazone group (insulin plus metformin versus insulin plus troglitazone, P = 0.004). Body weight increased by 0.5 kg in the insulin plus metformin group, whereas the other two groups gained 4.4 kg (P < 0.0001 vs. baseline). Triglyceride and VLDL triglyceride levels significantly improved only in the insulin plus troglitazone group. Subjects taking metformin experienced significantly more gastrointestinal side effects and less hypoglycemia.
CONCLUSIONS-Aggressive insulin therapy significantly improved glycemic control in type 2 diabetic subjects to levels comparable with those achieved by adding metformin to insulin therapy. Troglitazone was the most effective in lowering HbA(lc), total daily insulin dose, and triglyceride levels. However, treatment with insulin plus metformin was advantageous in avoiding weight gain and hypoglycemia.
Diabetes Care 2002 Oct;25(10):1691-8
|
|
|
|
|
|
| Search our website |
 |
| |
Would you like to know more about insulin resistance? Are you looking for information pertaining to Type 2 Diabetes? You can find what you are looking for in over 2000 references available on CMEonDiabetes. |
| |
|
|
| Social |
|
| |
Let others know about this presentation.
|
|
|
|
