Combined Therapy With Insulin Plus Oral Agents: Is There Any Advantage? An argument in favor  

Oleh:

Riddle, Matthew C.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 31 no. Sup 02 (Feb. 2008), page s125-s130.
Topik: Combined Therapy; insulin

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2008.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Combined therapy with insulin plus oral agents is widely used and has been shown to be effective in improving glycemic control in many short-term studies. The rationale for using combined regimens to minimize the dosage of antihyperglycemic agents and thereby their unwanted effects (hypoglycemia in the case of insulin) is clear. When oral therapy is continued during insulin therapy, enhancing either the availability or effectiveness of endogenous insulin, glycemic stability may improve and may lead to better glycemic control with similar hypoglycemic risk, or equal glycemic control with less hypoglycemia. In the case of metformin, combination with insulin also limits the risk of weight gain. However, only a few physiologic studies clarifying the mechanisms underlying these benefits are available, and longer-term medical outcome studies comparing insulin alone with insulin plus oral therapy are lacking. Evidence that insulin-metformin therapy can provide better glycemic control with less risk of hypoglycemia and little weight gain, compared with insulin alone, supports this combination as a standard method of treating type 2 diabetes to usual glycemic targets.

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