Combination sulfonylurea-insulin therapy for patients with diabetes mellitus has been evaluated by numerous investigators with various experimental designs. Much of the data are conflicting, and clear conclusions do not seem justified. Insulin-sulfonylurea therapy is probably not clinically useful in most patients with insulindependent diabetes mellitus. Most non-insulindependent diabetic (NIDOM) patients are also unlikely to have meaningful improvement in glycemic regulation on insulin-sulfonylurea therapy. A subset of NIDDM patients who are mildly to moderately obese, have adequate endogenous insulin secretory reserve, and are in poor glycemic regulation (fasting plasma glucose >11mM and/or HbA1 >10%), despite twice-daily insulin administration of >70 U/day, may show significant improvement of glycemic regulation and/or decreases in insulin daily dose on insulin-sulfonylurea therapy. The mechanisms by which insulin-sulfonylurea therapy improves glycemic regulation and decreases insulin requirements involve an increase in endogenous insulin secretion and possibly some extrapancreatic actions of the sulfonylureas on muscle and liver.
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Original Articles|
June 01 1990
Combination Insulin-Sulfonylurea Therapy
Harold E Lebovitz, MD;
Harold E Lebovitz, MD
Department of Medicine, Division of Endocrinology, State University of New York Health Science Center at Brooklyn
Brooklyn, New York
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RoseMarie Pasmantier, MD
RoseMarie Pasmantier, MD
Department of Medicine, Division of Endocrinology, State University of New York Health Science Center at Brooklyn
Brooklyn, New York
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Address correspondence and reprint requests to Harold E. Lebovitz, MD, Professor of Medicine, Box 1205, SUNY HSC at Brooklyn, 450 Clarkson Avenue, Brooklyn, NY 11203.
Citation
Harold E Lebovitz, RoseMarie Pasmantier; Combination Insulin-Sulfonylurea Therapy. Diabetes Care 1 June 1990; 13 (6): 667–675. https://doi.org/10.2337/diacare.13.6.667
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