TRIPLE ORAL ANTIDIABETIC OR METFORMIN-BASAL INSULIN COMBINATION: TESTING TWO DIFFERENT APPROACHES OF CONSENSUS ALGORITHM IN ADJUSTING ANTIDIABETIC THERAPY. AN OPEN-LABEL, RANDOMIZED STUDY


MESCI B., OGUZ A., KILIC D. C. , CELIK S. , SAHIN G., Tekin M. , ...Daha Fazla

ACTA ENDOCRINOLOGICA-BUCHAREST, cilt.8, ss.587-594, 2012 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Cilt numarası: 8 Konu: 4
  • Basım Tarihi: 2012
  • Doi Numarası: 10.4183/aeb.2012.587
  • Dergi Adı: ACTA ENDOCRINOLOGICA-BUCHAREST
  • Sayfa Sayıları: ss.587-594

Özet

Objective. The aim of this study was to compare the clinical effects of a triple oral antidiabetic combination versus basal insulin and metformin combination treatment in patients with poorly controlled type 2 diabetes.

Objective. The aim of this study was

to compare the clinical effects of a triple

oral antidiabetic combination versus basal

insulin and metformin combination

treatment in patients with poorly controlled

type 2 diabetes.

Methods. Eighty patients with type 2

diabetes, who were treated by metformin

and sulphonylurea combination, and had

HbA1c values between 7.5 and 10 % (58

and 86 mmol/L), were randomized into two

groups. The first group was given triple oral

antidiabetic therapy (pioglitazone,

metformin, and sulphonylurea) and the

second group was given metformin and a

bedtime basal insulin (insulin detemir)

combination for 12 weeks. Metabolic

parameters were evaluated.

Results. The mean fasting plasma

glucose and HbA1c levels decreased in both

groups. The decrease in HbA1c was slightly

higher in triple oral antidiabetic group

(p=0.046). The patients in triple oral

combination group gained 0.2 kg (p=0.881)

and those in the metformin-insulin detemir

combination group lost 1.7 kg (p=0.001) in

12 weeks (p=0.29 between groups). The

frequency of hypoglycemia was higher in

triple oral antidiabetic group (11 vs. 2

episodes, respectively).

Conclusion. Both sulphonyureametformin-

pioglitazone and insulin

detemir-metformin therapies provided

significant improvements in glycemic

control. However, sulphonylurea,

pioglitazone and metformin combination

led to more frequent hypoglycemic events,

and weight management seemed in favor of

insulin detemir-metformin combination.