Improved diabetic control in insulin-dependent diabetics treated with insulin and glibenclamide

A randomized double blind trial of insulin and glibenclamide treatment vs insulin and placebo was carried out in 20 insulin-dependent diabetics. Nine patients were C-peptide secretors and all increased their C-peptide output during a 50 g OGTT at the end of the insulin and glibenclamide treatment period by a mean of 47%. At the same time their mean daily blood glucose fell from 8.4 +/- 1.7 to 7.4 +/- 1.5 mmol/l and their HbA1 from 8.1 +/- 0.5 to 7.5 +/- 0.9% (mean +/- SD). There was no change in any of the measurements of diabetic control in C-peptide non-secretors and no evidence for any extra-pancreatic effects of glibenclamide in this group of patients. Combined insulin and glibenclamide treatment may produce a useful improvement of diabetic control in insulin-dependent diabetics who still secrete some endogenous insulin, although further studies are required.