Adding metformin versus insulin dose increase in insulin-treated but poorly controlled Type 2 diabetes mellitus: an open-label randomized trial
✍ Scribed by Relimpio, F.; Pumar, A.; Losada, F.; Mangas, M.A.; Acosta, D.; Astorga, R.
- Book ID
- 101218304
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 83 KB
- Volume
- 15
- Category
- Article
- ISSN
- 0742-3071
No coin nor oath required. For personal study only.
✦ Synopsis
To compare the effect of adding metformin to insulin therapy with a moderate increase in insulin dose alone in insulin-treated, poorly controlled Type 2 diabetic patients, 47 consecutive such patients (baseline daily dose Ͼ0.5 IU kg ؊1 and HbA 1c Ͼ8 %) were openly randomized either to a combination of their previous insulin schedule plus metformin (2.55 g daily in three divided doses, n ؍ 24) or to a moderate insulin dose increase (20 % of baseline, n ؍ 23). The patient status/biochemical profile was assessed at entry and at 4 months. Among those assigned to insulin ؉ metformin, 18 took the drug. Upon an intention-to-treat basis, patients assigned to insulin dose increase had a statistically significant weight gain (1.16 ؉ 1.9 vs 0.3 ؎ 4.5 kg, p Ͻ 0.05). Patients assigned to the insulin ؉ metformin regimen experienced a significantly greater fall in HbA 1c (؊1.87 ؎ 2.16 vs 0.03 ؎ 1.68 %, p Ͻ 0.01), total cholesterol (؊0.56 ؎ 0.89 vs 0.14 ؎ 0.72 mmol l ؊1 , p Ͻ 0.05) and LDL-cholesterol (؊0.51 ؎ 0.73 vs 0.19 ؎ 0.6 mmol l ؊1 , p Ͻ 0.01). These data suggest that adding metformin to insulin in poorly controlled Type 2 DM patients offers an advantage in terms of glycaemic control and lipid plasma profile.