Effects of the combination of insulin and gliclazide compared with insulin alone in type 2 diabetic patients with secondary failure to oral hypoglycemic agents

Aschner, Pablo; Kattah, William

doi:10.1016/0168-8227(92)90051-r

Cited by 5 publications

(3 citation statements)

References 33 publications

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“…However, only 12 patients (48%) were able to maintain their FPG levels below 140 mg/ dl and 8 of them (32%) normalized them. Despite the heterogeneity of our sample concerning age, duration of diabetes and BMI distribution which could have influenced our results, our data are similar to others (15)(16)(17). Nevertheless the exact mechanism underlying the non-response to combined therapy in some patients has not been established.…”

Section: Discussionsupporting

confidence: 80%

“…When SU was withdrawn (phase 3), a 50% increase in insulin dose was observed, as also reported in other studies (9,11,(14)(15)(16)(17)21,22). Despite this increment, only three patients among those who responded to combined therapy maintained their FPG below 140 mg/dl in phase 3 (P<0.02).…”

Section: Discussionsupporting

confidence: 63%

“…These results demonstrate a greater influence of combined therapy on FPG than on postprandial glucose (11,15,23). This fact may be attributed to the suppression of hepatic production of glucose by NPH insulin given at bedtime (11,24).…”

Section: Discussionmentioning

confidence: 67%

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Gliclazide and bedtime insulin are more efficient than insulin alone for type 2 diabetic patients with sulfonylurea secondary failure

Chazan

Gomes

2001

Braz J Med Biol Res

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To determine the effects of combined therapy of gliclazide and bedtime insulin on glycemic control and C-peptide secretion, we studied 25 patients with type 2 diabetes and sulfonylurea secondary failure, aged 56.8 ± 8.3 years, with a duration of diabetes of 10.6 ± 6.6 years, fasting plasma glucose of 277.3 ± 64.6 mg/dl and a body mass index of 27.4 ± 4.8 kg/m 2 . Patients were submitted to three therapeutic regimens lasting 2 months each: 320 mg gliclazide (phase 1), 320 mg gliclazide and bedtime NPH insulin (phase 2), and insulin (phase 3). At the end of each period, glycemic and C-peptide curves in response to a mixed meal were determined. During combined therapy, there was a decrease in all glycemic curve values (P<0.01). Twelve patients (48%) reached fasting plasma glucose <140 mg/dl with a significant weight gain of 64.8 kg (43.1-98.8) vs 66.7 kg (42.8-101.4) (P<0.05), with no increase in C-peptide secretion or decrease in HbA1. CPeptide glucose score (C-peptide/glucose x 100) increased from 0.9 (0.2-2.1) to 1.3 (0.2-4.7) during combined therapy (P<0.01). Despite a 50% increase in insulin doses in phase 3 (12 U (9-30) vs 18 U (11-60); P<0.01) only 3 patients who responded to combined therapy maintained fasting plasma glucose <140 mg/dl (P<0.02). A tendency to a higher absolute increase in C-peptide (0.99 (0.15-2.5) vs 0.6 (0-2.15); P = 0.08) and C-peptide incremental area (2.47 (0.22-6.2) vs 1.2 (0-3.35); P = 0.07) was observed among responders. We conclude that combined therapy resulted in a better glucose response to a mixed meal than insulin alone and should be tried in type 2 diabetic patients before starting insulin monotherapy, despite difficulties in predicting the response.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 63%

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Gliclazide and bedtime insulin are more efficient than insulin alone for type 2 diabetic patients with sulfonylurea secondary failure

Chazan

Gomes

2001

Braz J Med Biol Res

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Current Position of Gliclazide and Sulfonylureas in the Contemporary Treatment Paradigm for Type 2 Diabetes: A Scoping Review

Sahin,

Bakiner,

Demir

et al. 2024

Diabetes Ther

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The increasing burden of type 2 diabetes (T2D), in relation to alarming rise in the prevalence; challenges in the diagnosis, prevention, and treatment; as well as the substantial impact of disease on longevity and quality of life, is a major concern in healthcare worldwide. Sulfonylureas (SUs) have been a cornerstone of T2D pharmacotherapy for over 60 years as oral antidiabetic drugs (OADs), while the newer generation SUs, such as gliclazide modified release (MR), are known to be associated with low risk of hypoglycemia in addition to the cardiovascular neutrality. This scoping review aimed to specifically address the current position of gliclazide MR among other SUs in the contemporary treatment paradigm for T2D and to provide a practical guidance document to assist clinicians in using gliclazide MR in real-life clinical practice. The main topics addressed in this paper include the role of early and sustained glycemic control and use of SUs in T2D management, the properties of gliclazide MR in relation to its effectiveness and safety, the use of gliclazide therapy in special populations, and the place of SUs as a class and gliclazide MR specifically in the current T2D treatment algorithm.

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Gliclazide modified release: Its place in the therapeutic Armamentarium

Crepaldi¹,

Fioretto²

2000

Metabolism

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Effects of the combination of insulin and gliclazide compared with insulin alone in type 2 diabetic patients with secondary failure to oral hypoglycemic agents

Cited by 5 publications

References 33 publications

Gliclazide and bedtime insulin are more efficient than insulin alone for type 2 diabetic patients with sulfonylurea secondary failure

Gliclazide and bedtime insulin are more efficient than insulin alone for type 2 diabetic patients with sulfonylurea secondary failure

Current Position of Gliclazide and Sulfonylureas in the Contemporary Treatment Paradigm for Type 2 Diabetes: A Scoping Review

Gliclazide modified release: Its place in the therapeutic Armamentarium

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