(HealthDay)—Adding a sulfonylurea or metformin to insulin is associated with approximately a 1 percent reduction in hemoglobin A1c (HbA1c), and addition of a sulfonylurea (but not metformin) is associated with more hypoglycemic events, according a clinical evidence synopsis published online Oct. 17 in the Journal of the American Medical Association.
Rimke C. Vos, Ph.D., and Guy E.H.M. Rutten, M.D., Ph.D., from University Medical Center Utrecht in the Netherlands, summarized a research review of studies that examined the effect of the addition of oral hypoglycemic agents among patients with type 2 diabetes who do not achieve optimal glycemic control with insulin monotherapy.
The researchers found that adding a sulfonylurea to insulin was correlated with more hypoglycemic events than insulin alone; this was not seen for metformin. There was an approximate 1 percent decrease in HbA1c with the addition of a sulfonylurea or metformin to insulin.
“Future randomized clinical trials could address the effect of adding oral hypoglycemic agents to insulin therapy for the outcomes of diabetes-related morbidity and mortality, all-cause mortality, and quality of life,” the authors write.
The authors disclosed ties to the pharmaceutical industry.
Exenatide, pioglitazone effective for poorly controlled T2DM
Abstract/Full Text (subscription or payment may be required)