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Combination therapy with insulin and metformin
1Swedish Network for Pharmacoepidemiology, Malmö, Sweden.
Summary
Metformin combined with insulin is effective for managing type 2 diabetes (NIDDM). This combination helps reduce insulin resistance and may improve cardiovascular health, particularly in obese patients on high insulin doses.
Area of Science:
- Endocrinology
- Pharmacology
- Metabolic Diseases
Background:
- Insulin therapy is often necessary for patients with non-insulin-dependent diabetes mellitus (NIDDM) when oral agents fail.
- Metformin is known to improve insulin sensitivity and counteract weight gain.
Purpose of the Study:
- To review the clinical utility of combining insulin with metformin for diabetes management.
- To assess the efficacy and safety of this combination therapy.
Main Methods:
- Review of clinical documentation and controlled studies on insulin and metformin combination therapy.
- Consideration of basic principles of insulin use in NIDDM and metformin's interaction with insulin.
Main Results:
- Metformin enhances insulin's effects, reducing insulin needs and improving glycemic control in NIDDM.
- The combination is well-tolerated and approved in several countries, potentially benefiting obese patients with NIDDM on high insulin doses.
- Metformin may also be considered for selected patients with insulin-dependent diabetes mellitus (IDDM).
Conclusions:
- Metformin is an effective adjunct to insulin therapy in NIDDM.
- It may be a preferable alternative to sulfonylureas in obese NIDDM patients with high insulin requirements due to its effects on insulin resistance.
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