Combined glyburide and insulin therapy in type II diabetes

Present treatment of type II diabetes mellitus often fails to normalize post-prandial glucoses. A placebo-controlled, double-blinded design tested the effects of combined glyburide-insulin therapy over 4 months in 20 patients after achieving good control of fasting glucose with diet and intermediate insulin alone. Insulin requirements significantly decreased in both groups during the initial hospitalization when drug or placebo was added, presumably because of enforced dietary compliance. Thereafter, post-prandial glucoses worsened in the placebo group, as did hemoglobin A1c; neither of these parameters changed on the glyburide group by week 16, except for modest reduction of the 2h post-lunch glucose. Thus, while combined therapy provides little advantage beyond what can be accomplished with effective doses of intermediate insulin alone, it did reduce the need for this exogenous insulin.