Treatment of NIDDM in secondary failure on sulfonylureas with prandial regular insulin injections.
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NIDDM is a disease with decreased meal-related insulin secretion but with possible near-normal basal insulin. Therefore, the substitution of prandial insulin by injections of regular insulin was tested in NIDDM with secondary failure on sulfonylureas.<BR>Fifteen consecutive nonobese NIDDM patients participated in the study. All had been admitted to hospitals because of poor glycemic control due to secondary failure with long-term sulfonylurea treatment (age: 52.1+10.4 years (M + SD), estimated duration of DM: 15.2+ 7.5 years, duration of sulfonylureas administration: 7.0+2.2 years).<BR>Patients were given regular insulin 30 min preprandially for 3 meals. Insulin injections were begun at doses of 10U, 8U and 6U for breakfast, lunch and dinner, respectively. Then, according to the daily profile of plasma glucose taken every 3-4 days, doses were adjusted to obtain normal pre-and 2-h postprandial glycemias.<BR>At 4 weeks after the initiation of insulin treatment, in 13 out of 15 patients (51.5±10.9 kg) perfect normalization of both meal-related and pre-breakfast glycemias was established with insulin doses of 10.5±2.6U, 8.8±2.4U and 7.1±2.7U, for breakfast, lunch, and dinner, respectively. Only 2 patients required additional bedtime long-acting insulin to obtain pre-breakfast normoglycemia. There was no significant difference in urinary C-peptide excretion rate from 11 pm to 7 am between the 13 responders and the 2 others.<BR>It was demonstrated that in nonobese NIDDM with secondary failure on sulfonylureas, 3 injections of sufficient regular insulin before each meal could control glycemia throughout the day.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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