Adjunctive Use of Tolazamide in Newly-Diagnosed Diabetic Children

Abstract

Recent data suggests that one of the major actions of sulfonylureas is to potentiate the anabolic cellular effects of insulin. This is the first study to examine the use of sulfonylureas as adjunctive therapy in newly-diagnosed type I diabetic children. A random, prospective, double blind study over 15 months, stratified by age at diagnosis, was conducted. The treatment group (n = 13) received daily oral weight-adjusted tolazamide whereas the control group (n = 11) received placebo. Monthly comparison of the HbA1 values between groups revealed no statistical difference; likewise, the fasting serum C-peptide values were not dissimilar. The mean daily insulin dose per kilogram, however, was less in the tolazamide group (P less than 0.001). The data suggests that the addition of tolazamide may not be of therapeutic benefit in newly diagnosed juvenile diabetics, although insulin requirements may be reduced.

A systematic review and meta‐analysis of interventions to preserve insulin‐secreting β‐cell function in people newly diagnosed with type 1 diabetes: Results from intervention studies aimed at improving glucose control

“…For sulphonylurea adjunctive therapy, there were three studies with 75 participants 40–42 . Only one of the studies 40 reported on insulin dose, but baseline imbalances between groups preclude meaningful interpretation.…”

“…For sulphonylurea adjunctive therapy, there were three studies with 75 participants 40–42 . Only one of the studies 40 reported on insulin dose, but baseline imbalances between groups preclude meaningful interpretation. Meta ‐analysis of two studies 40,42 indicated there was evidence of a difference between adjunctive treatment with sulphonylurea and control with regard to effect on HbA 1c up to 12 months of follow‐up (−5.7 mmol/mol (−0.52%) 95% CI: −16.4 (−1.5%) to 4.9 (0.45%); p = 0.29).…”

“…[40][41][42] Only one of the studies 40 reported on insulin dose, but baseline imbalances between groups preclude meaningful interpretation. Meta -analysis of two studies 40,42 indicated there was evidence of a difference between adjunctive treatment with sulphonylurea and control with regard to effect on HbA 1c up to 12 months of follow-up (−5.7 mmol/mol (−0.52%) 95% CI: −16.4 (−1.5%) to 4.9 (0.45%); p = 0.29). Although one of the two studies 42 did show a nonsignificant benefit with sulphonylurea at 6, 12 and 18 months.…”