Summary
Eleven Type 2 (non-insulin-dependent) diabetic patients, islet cell autoantibodies
negative, nonobese with secondary failure to oral hypoglycemic agents (OHA) [glyburide
(7.5 mg/day) and phenformin (75 mg/day)] and HbA1c 10.2±0.6% were studied. Insulin
receptors on circulating monocytes, glucose utilization at supraphysiological insulin
concentrations, and plasma C-peptide after i. v. glucagon were evaluated before and
after 2 months of combined therapy with OHA and insulin (Ultratard HM Novo).
A significant improvement was demonstrated in HbA1c and glycemia after two months
of treatment. Glucose MCR was increased after two months of treatment whilst basal
C-peptide was decreased as well as receptor binding to monocytes. After three years
of combined therapy, body weight, glycemia and HbA1c did not increase.
After three years the C-peptide basal values were significantly increased with respect
to values found after 2 months of therapy.
These results demonstrate that insulin treatment may restore insulin sensitivity in
NIDDM patients resistant to OHA treatment and that after three years there is no exhaustion
of B-cell function.
Key words
Beta Cell Exhaustion - Oral Hypoglycemic Agents - Insulin Combined Therapy - NIDDM
- Secondary Failure
