Outcome of reinitiation of combination anti diabetic oral therapy in insulin treated patients with Type 2 Diabetes Mellitus

Background: Before adding metformin to oral anti diabetic drugs, only sulfonylureas were
available. When sulfonylureas failed, insulin therapy had to be initiated. For this reason utilization
of insulin was more than now. The purpose of this study is evaluation of success in reinitiation of
oral therapy in insulin treated patients with type 2 diabetes.
Methods and Materials: This study is an outcome study, we attempted reinitiation of
combination oral therapy with metformin and a sulfonylurea in 32 patients who had type 2
diabetes for less than 30 years and had received less than 40U insulin for less than 10 years.
Results: Of 32 patients, reinitiation of oral therapy was successful in 20 patients and
unsuccessful in 12 (P=0.014). In 13 of 16 patients with less than 10 years diabetes duration , and
in 7 of 16 patients with more than 10 years diabetes duration, reinitiation of oral therapy was
successful(P=0.028).In patients who received 10-25 U/day , %76, and in patients who received 26-
40 U/day , %46.7, reinitiation of oral therapy was successful (P=0.05).There was not association
between reinitiation of oral therapy and age, duration of insulin therapy, dose of insulin and BMI.
Conclusions: This study shows reinitiation of combination oral therapy in insulin treated patients
with type 2 diabetes, is most likely to be successful with a shorter duration of diabetes and lower
insulin requirements.