[Treatment of type 2 diabetes. Early detection of secondary oral treatment failure is important]

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P Clauson1, S Efendic

  • 1Novo Nordisk A/S, Danmark.

Lakartidningen
|February 10, 1999
PubMed

Insights

Type II diabetes treatment involves oral hypoglycaemic agents (OHAs) and, if needed, bedtime NPH insulin. This combination offers metabolic control comparable to intensive insulin therapy with reduced weight gain risk.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Type II diabetes is characterized by reduced insulin secretion and increased insulin resistance.
  • Management involves lifestyle modification and oral hypoglycaemic agents (OHAs).
  • Newer OHAs are continually being developed and approved.

Purpose of the Study:

  • To evaluate treatment strategies for type II diabetes, particularly after OHA treatment failure.
  • To assess the efficacy and safety of combining daytime OHAs with bedtime NPH insulin.

Main Methods:

  • Review of current treatment guidelines and pharmacological interventions for type II diabetes.
  • Analysis of treatment outcomes for patients experiencing OHA failure.
  • Comparison of combination therapy (OHA + NPH insulin) with intensive insulin treatment.

Main Results:

  • Treatment failure with OHAs occurs in 5-10% of patients.
  • Combination therapy with daytime OHAs and bedtime NPH insulin achieves comparable metabolic control to intensive insulin therapy.
  • This combination therapy presents a lower risk of weight gain compared to intensive insulin treatment.

Conclusions:

  • Combination therapy offers an effective alternative for type II diabetes patients with OHA treatment failure.
  • NPH insulin at bedtime, combined with daytime OHAs, provides a viable strategy for managing hyperglycemia.
  • This approach balances glycemic control with a reduced risk of adverse effects like weight gain.

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