Comparing the effect of treatment with insulin alone versus insulin plus sulfonylurea in type 2 diabetic patients

  Background: Insulin is administered for glycemic control in type 2 diabetic patients with secondary failure to oral antidiabetic drugs . Achieving good glycemic control requires a long time with relatively high insulin dose.   Objective: The aim of this study was to compare the effect of treatment with insulin alone versus insulin plus sulfonylurea in type 2 diabetic patients .   Methods: In this randomized clinical trial, 45 patients with secondary failure to oral antidiabetic drugs who referred to Bou-Ali hospital during 2009-2010, were randomly allocated into two groups of insulin alone and insulin plus sulfonylurea. Fasting and postprandial blood sugar, insulin dose, and weight gain were measured monthly up to 3 months. Data were analyzed by T-test and Chi-square test.   Findings: A t the end of the first and the third month of the treatment, mean fasting blood sugar was 146.3 ±21.1 mg/dl and 126.9±10.2 mg/dl in combination therapy group and was 166.1 ± 28.7 mg/dl and 144.5 ± 20.9 mg/dl in insulin alone group, respectively ( P =0.01 and P=0.001, respectively). Mean postprandial blood sugar in combination group was lower than insulin alone group at the end of the third month (P=0.009). The difference in mean insulin dose between 2 groups was statistically significant at the end of the third month (P<0.001).   Conclusion: With regard to the results, combination therapy with insulin plus sulfonylurea versus insulin alone would result in faster improvement of glycemic control and lower daily insulin dose.