Combination therapy with insulin and oral agents: optimizing glycemic control in patients with type 2 diabetes mellitus.


:The United Kingdom Prospective Diabetes Study (UKPDS) showed that tight glycemic control with any of several therapeutic regimens has the potential to significantly reduce the risk for long-term microvascular complications of type 2 diabetes. An important question that remains to be answered is what is the best approach to optimizing glycemic control in patients with this disease. This article reviews results of studies in which insulin was used alone or in combination with oral antidiabetic agents for treatment of patients with type 2 diabetes. Analysis of comparative studies (13 in insulin-naive and 26 in previously insulin-treated patients) showed that combination therapy involving one to two insulin injections per day plus oral therapy is usually more effective than insulin monotherapy for achieving and maintaining glycemic control. Combination treatment for type 2 diabetes can be significantly improved by newly developed preparations that lack the major limitations of older products. Once-daily administration of isophane insulin (NPH insulin) is limited by a 15-18-h duration of action and a peak effect that occurs about 6 h after injection. Insulin glargine, a new insulin analogue developed using recombinant DNA technology, has a flat pharmacodynamic profile and a 24-h duration of action. Results from a recent comparative study indicate that insulin glargine plus oral therapy may provide better post-dinner glucose control as well as less symptomatic and nocturnal hypoglycemia than oral therapy combined with NPH insulin. The studies reviewed in the present article support the conclusion that combination therapy with insulin glargine combined with one or more oral antidiabetic agents may be the treatment of choice for achieving glycemic control in patients with type 2 diabetes.


Diabetes Metab Res Rev


Yki-Järvinen H





Has Abstract


2002-09-01 00:00:00








18 Suppl 3


  • Serum protein patterns in newly diagnosed type 2 diabetes mellitus--influence of diabetic environment and family history of diabetes.

    abstract:BACKGROUND:Individuals with normal glucose tolerance (NGT) and type 2 diabetes mellitus (T2DM) represent heterogeneous groups with differences in beta-cell function and genetic background. The aim of the present study was to compare serum protein profiles of NGT and T2DM individuals and determine the influence of the g...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Sundsten T,Ostenson CG,Bergsten P

    更新日期:2008-02-01 00:00:00

  • Serum ferritin and glucose homeostasis: change in the association by glycaemic state.

    abstract:BACKGROUND:Data on the association between body iron and glucose homeostasis by the three glycaemic states are scarce. Thus, we investigated the association between body iron as assessed by a serum ferritin concentration and glucose homeostasis using homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) a...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Aregbesola A,Virtanen JK,Voutilainen S,Mursu J,Lagundoye A,Kauhanen J,Tuomainen TP

    更新日期:2015-07-01 00:00:00

  • Statin users have an elevated risk of dysglycemia and new-onset-diabetes.

    abstract:OBJECTIVE:Statins are one of the most widely prescribed medications in the United States; however, there is a concern that they are associated with new-onset-diabetes (NOD) development. We sought to understand the risk of dysglycemia and NOD for a cohort of individuals that reflect real-world physician prescribing patt...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Zigmont VA,Shoben AB,Lu B,Kaye GL,Clinton SK,Harris RE,Olivo-Marston SE

    更新日期:2019-11-01 00:00:00

  • Impact of unhealthy childhood and unfavorable parents' characteristics on adiposity in schoolchildren.

    abstract:BACKGROUND:Childhood obesity is encouraged by low physical activity (PA), time spent using screens (screen time, ST), and by sugar-sweetened beverage consumption (SSBc). It is also influenced by unfavorable parents' characteristics, such as a high body mass index (BMI) and low education level (EL). Our aim was to evalu...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Vinciguerra F,Tumminia A,Roppolo F,Romeo LC,La Spina N,Baratta R,Parrino C,Sciacca L,Vigneri R,Frittitta L

    更新日期:2019-11-01 00:00:00

  • Implementation of a quality improvement initiative in Belgian diabetic foot clinics: feasibility and initial results.

    abstract:BACKGROUND:This article aims to describe the implementation and initial results of an audit-feedback quality improvement initiative in Belgian diabetic foot clinics. METHODS:Using self-developed software and questionnaires, diabetic foot clinics collected data in 2005, 2008 and 2011, covering characteristics, history ...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Doggen K,Van Acker K,Beele H,Dumont I,Félix P,Lauwers P,Lavens A,Matricali GA,Randon C,Weber E,Van Casteren V,Nobels F,Initiative for Quality Improvement and Epidemiology in Diabetic Foot Clinics (IQED-Foot) Study Group.

    更新日期:2014-07-01 00:00:00

  • The effects of thyroid hormones on brown adipose tissue in humans: a PET-CT study.

    abstract:BACKGROUND:Brown adipose tissue (BAT) is important for energy expenditure through thermogenesis, although its regulatory factors are not well known in humans. There is evidence suggesting that thyroid hormones affect BAT functions in some mammals, but the effects of thyroid hormones on BAT activity in humans are still ...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Zhang Q,Miao Q,Ye H,Zhang Z,Zuo C,Hua F,Guan Y,Li Y

    更新日期:2014-09-01 00:00:00

  • Association of serum 25-hydroxyvitamin D with type 2 diabetes and markers of insulin resistance in a general older population in Finland.

    abstract:BACKGROUND:Vitamin D insufficiency and type 2 diabetes are both common in Finland, and low vitamin D status has been suggested as a risk factor for type 2 diabetes. Our aim was to study the associations between serum 25-hydroxyvitamin D [25(OH)D], a marker of vitamin D status, and glucose homeostasis and type 2 diabete...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Hurskainen AR,Virtanen JK,Tuomainen TP,Nurmi T,Voutilainen S

    更新日期:2012-07-01 00:00:00

  • Diabetic fatty liver disease is associated with specific changes in blood-borne markers.

    abstract:BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) can lead to cirrhosis and hepatocellular carcinoma and is strongly associated with obesity and insulin resistance. The aim of this study was to assess if plasma markers associated with NAFLD are increased in people with concomitant diabetes compared with those withou...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Sharma S,Barrett F,Adamson J,Todd A,Megson IL,Zentler-Munro PL,MacRury SM

    更新日期:2012-05-01 00:00:00

  • The shape of plasma glucose concentration curve during OGTT predicts future risk of type 2 diabetes.

    abstract:BACKGROUND:The aim of the study is to assess the relationship between the shape of plasma glucose concentration during the OGTT and future risk for T2DM. METHODS:2445 non-diabetic subjects from the Botnia study received an OGTT at baseline and after 7-8 years of follow-up. RESULTS:NGT and IFG subjects who returned th...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Abdul-Ghani MA,Lyssenko V,Tuomi T,Defronzo RA,Groop L

    更新日期:2010-05-01 00:00:00

  • Hyperbaric oxygen therapy and the diabetic foot.

    abstract::Common causes for non-healing of diabetic foot ulcers are infection and/or ischaemia. Diabetic patients are compromised hosts as far as wound healing is concerned. Diabetes mellitus is associated with a defective cellular and humoral immunity. In particular, decreased chemotaxis, decreased phagocytosis, impaired bacte...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: Bakker DJ

    更新日期:2000-09-01 00:00:00

  • Glucose monitoring by reverse iontophoresis.

    abstract::Glucose can be extracted through intact skin by electro-osmotic flow (a process called 'reverse iontophoresis') upon the application of a low-level electrical current. Recently we have combined iontophoretic extraction with an in situ glucose sensor in a device called the GlucoWatch biographer. Clinical results with t...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: Potts RO,Tamada JA,Tierney MJ

    更新日期:2002-01-01 00:00:00

  • Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: a systematic review.

    abstract::Non-invasive tests for the detection of peripheral artery disease (PAD) among individuals with diabetes mellitus are important to estimate the risk of amputation, ulceration, wound healing and the presence of cardiovascular disease, yet there are no consensus recommendations to support a particular diagnostic modality...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: Brownrigg JR,Hinchliffe RJ,Apelqvist J,Boyko EJ,Fitridge R,Mills JL,Reekers J,Shearman CP,Zierler RE,Schaper NC,International Working Group on the Diabetic Foot.

    更新日期:2016-01-01 00:00:00

  • Can molecular DNA-based techniques unravel the truth about diabetic foot infections?

    abstract::Diabetes foot infections are a common condition and a major causal pathway to lower extremity amputation. Identification of causative pathogens is vital in directing antimicrobial therapy. Historically, clinicians have relied upon culture-dependent techniques that are now acknowledged as both being selective for micro...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: Malone M,Gosbell IB,Dickson HG,Vickery K,Espedido BA,Jensen SO

    更新日期:2017-01-01 00:00:00

  • The important role of physical activity in the prevention and management of gestational diabetes mellitus.

    abstract::The actual pathophysiology behind gestational diabetes mellitus (GDM) is still unclear, but a deterioration in insulin resistance beyond that induced by pregnancy, combined with beta cell dysfunction, plays a key role. Interventions that help improve glucose tolerance by attenuating pregnancy-induced insulin resistanc...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: Ruchat SM,Mottola MF

    更新日期:2013-07-01 00:00:00

  • A subset of human pancreatic beta cells express functional CD14 receptors: a signaling pathway for beta cell-related glycolipids, sulfatide and β-galactosylceramide.

    abstract:BACKGROUND:T1DM is a T-cell-mediated autoimmune disease targeting insulin-producing beta-cells. Multiple factors may contribute to the development of T1DM. Among these, the metabolic state of beta-cells and pro-inflammatory cytokines, produced by infiltrating immune cells, have been implicated in the precipitation of T...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Osterbye T,Funda DP,Fundová P,Månsson JE,Tlaskalová-Hogenová H,Buschard K

    更新日期:2010-11-01 00:00:00

  • Diabetes trends in Africa.

    abstract::Diabetes is an important cause of morbidity and mortality in Africa. Although a dramatic increase in disease burden is projected, it remains to be seen what effect the ongoing devastation of HIV disease will have on the epidemiology of such chronic diseases as diabetes. Recent data on type 2 diabetes prevalence indica...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: Motala AA

    更新日期:2002-09-01 00:00:00

  • Programmed disorders of beta-cell development and function as one cause for type 2 diabetes? The GK rat paradigm.

    abstract::Now that the reduction in beta-mass has been clearly established in humans with type 2 diabetes mellitus (T2DM) 1-4, the debate focuses on the possible mechanisms responsible for decreased beta-cell number and impaired beta-cell function and their multifactorial etiology. Appropriate inbred rodent models are essential...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: Portha B

    更新日期:2005-11-01 00:00:00

  • Association of iron indices and type 2 diabetes: a meta-analysis of observational studies.

    abstract::The literature on the role of body iron status in the development of type 2 diabetes (T2D) in humans is inconsistent. We aimed to assess the association between iron indices and T2D by a meta-analysis of previously published studies. A systematic literature search was conducted in PubMed and EMBASE. Observational stud...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,meta分析,评审


    authors: Orban E,Schwab S,Thorand B,Huth C

    更新日期:2014-07-01 00:00:00

  • Self-monitoring of blood glucose in type-2 diabetes: what is the evidence?

    abstract:BACKGROUND:There is a controversy about self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes who are not using insulin. Randomized trials are limited in duration, size, and validity. METHODS:Systematic search for randomized trials and observational studies published since 1990. For inclusion studie...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: McGeoch G,Derry S,Moore RA

    更新日期:2007-09-01 00:00:00

  • Assessment of the relationship between hypoglycaemia awareness and autonomic function following islet cell/pancreas transplantation.

    abstract:BACKGROUND:This study assesses the autonomic function of patients who have regained awareness of hypoglycaemia following islet cell or whole pancreas transplant. METHODS:Five patients with type 1 diabetes and either islet cell (four patients) or whole pancreas (one patient) transplant were assessed. These patients wer...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Kamel JT,Goodman DJ,Howe K,Cook MJ,Ward GM,Roberts LJ

    更新日期:2015-09-01 00:00:00

  • Comparing glucose and hemoglobin A1c diagnostic tests among a high metabolic risk Hispanic population.

    abstract:BACKGROUND:Compare glycated hemoglobin (HbA1c ) diagnostic tests for prediabetes and diabetes with plasma glucose criteria and compare the metabolic profiles of people classified by HbA1c versus by glucose levels. METHODS:Participants were recruited for the San Juan Overweight Adults Longitudinal Study. The participan...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Vega-Vázquez MA,Ramírez-Vick M,Muñoz-Torres FJ,González-Rodríguez LA,Joshipura K

    更新日期:2017-05-01 00:00:00

  • Coincident diabetes mellitus and primary hyperparathyroidism.

    abstract::The prevalence of diabetes mellitus in primary hyperparathyroidism is approximately 8% and that of primary hyperparathyroidism in diabetic patients is approximately 1%. Both values are about three-fold higher than the respective expected prevalences in general populations. Patients with both disorders are over 40 year...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: Taylor WH,Khaleeli AA

    更新日期:2001-05-01 00:00:00

  • Diabetic atrial fibrillation patients: mortality and risk for stroke or embolism during a 10-year follow-up.

    abstract:BACKGROUND:To compare in atrial fibrillation patients with and without diabetes, (1) baseline characteristics, (2) additional risk factors for stroke or peripheric or visceral embolism (hypertension, previous stroke, age >75 years), (3) mortality, (4) stroke or embolism, and (5) oral anticoagulation in the year 2000. ...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Klem I,Wehinger C,Schneider B,Hartl E,Finsterer J,Stöllberger C

    更新日期:2003-07-01 00:00:00

  • Predicting ulcer-free survival using the discriminative value of screening test locations.

    abstract:BACKGROUND:Current guidelines recommend screening the feet of diabetic subjects with a 10-g monofilament or tuning fork. We investigated which tests and locations on the feet have the best predictive value regarding 1-year ulcer-free survival in diabetic subjects participating in the prospective Rotterdam Diabetic Foot...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Rinkel WD,van der Oest MJW,Dijkstra DA,Castro Cabezas M,Coert JH

    更新日期:2019-03-01 00:00:00

  • The value of ankle-branchial index screening for cardiovascular disease in type 2 diabetes.

    abstract:OBJECTIVE:To investigate the relationship between ankle-branchial index (ABI) and cardiovascular disease in type 2 diabetes patients. METHODS:A total of 634 inpatients with type 2 diabetes were recruited in this cross-sectional study. All patients were measured with ABI and computed tomography angiography (CTA) scan f...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Xu L,He R,Hua X,Zhao J,Zhao J,Zeng H,Li L,Liu F,Jia W

    更新日期:2019-01-01 00:00:00

  • Urinary biomarkers involved in type 2 diabetes: a review.

    abstract::Diabetes mellitus is one of the most challenging health concerns of the 21st century. With at least 30% of the diabetic population remaining undiagnosed, effective and early diagnosis is of critical concern. Development of a diagnostic test, more convenient and reliable than those currently used, would therefore be hi...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章,评审


    authors: Matheson A,Willcox MD,Flanagan J,Walsh BJ

    更新日期:2010-03-01 00:00:00

  • Subcutaneous adipose tissue expression of plasminogen activator inhibitor-1 (PAI-1) in nondiabetic and Type 2 diabetic subjects.

    abstract:OBJECTIVE:Increased plasma levels of plasminogen activator inhibitor-1 (PAI-1) have been suggested to be a part of the insulin resistance syndrome, and recent data suggest that adipose tissue participates in the production of PAI-1. We examined the expression and insulin regulation of subcutaneous adipose tissue PAI-1 ...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Koistinen HA,Dusserre E,Ebeling P,Vallier P,Koivisto VA,Vidal H

    更新日期:2000-09-01 00:00:00

  • An increase in inflammation and islet dysfunction is a feature of prediabetes.

    abstract:AIMS:Type 2 diabetes (T2D) is a global health problem that will be diagnosed in almost 300 million people by 2025 according to the World Health Organization. Before being diagnosed with T2D, individuals may have glucose levels above normal but below the diabetic range. This condition is known as prediabetes. Studies sh...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Weaver JR,Odanga JJ,Breathwaite EK,Treadwell ML,Murchinson AC,Walters G,Fuentes DP,Lee JB

    更新日期:2020-09-10 00:00:00

  • Widening awareness of hyperglycemia unawareness.

    abstract::Hyperglycemia unawareness is the term suggested to me (M. Muggeo, personal communication, 1997) to encompass very broadly all of the stages in diabetes mellitus from the onset of any degree of hyperglycemia until the diagnosis is actually made. Diabetes and its handmaiden, obesity, are growing in epidemic proportions ...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 评论,社论


    authors: Roth J

    更新日期:2000-07-01 00:00:00

  • The association between fasting plasma glucose and all-cause and cause-specific mortality by gender: The rural Chinese cohort study.

    abstract:BACKGROUND:To evaluate the association between fasting plasma glucose (FPG) and mortality by gender. METHODS:A total of 17 248 eligible participants from a rural Chinese prospective cohort population were included. The same questionnaire interview and anthropometric and laboratory measurements were performed at both b...

    journal_title:Diabetes/metabolism research and reviews

    pub_type: 杂志文章


    authors: Liu L,Chen X,Liu Y,Sun X,Yin Z,Li H,Zhang M,Wang B,Ren Y,Zhao Y,Liu D,Zhou J,Liu X,Zhang D,Cheng C,Liu F,Zhou Q,Xu Q,Xiong Y,Liu J,You Z,Hong S,Wang C,Hu D

    更新日期:2019-05-01 00:00:00