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Insulin therapy metformin combination

Several years have passed since you have been following MF s therapy. His weight is down to 230 lb (104.6 kg), and he tries to maintain his diet and exercise. His recent HbAlc levels have increased up to 8.4% from 7.2% despite combination therapy with sulfonylureas and metformin. The physician believes that it is time to start insulin therapy for MF and asks you to initiate therapy and follow his regimen. [Pg.657]

Should secondary failure occur with metformin or sulfonylurea monotherapy, combined therapy with metformin and sulfonylurea may result in a response. Should secondary failure occur with combined therapy, it may be necessary to consider therapeutic alternatives, including initiation of insulin therapy. [Pg.324]

Combination therapy - When rosiglitazone is added to existing therapy, the current dose of sulfonylurea, insulin, or metformin can be continued upon initiation of rosiglitazone therapy. [Pg.326]

Strowig SM, Aviles-Santa ML, Raskin P. Comparison of insulin monotherapy and combination therapy with insulin and metformin or insulin and troglitazone in type 2 diabetes. Diabetes Care 2002 25(10) 1691-8. [Pg.379]

Furlong NJ, Hulme SA, O Brien SV, Hardy KJ. Repaglinide versus metformin in combination with bedtime NPH insulin in patients with type 2 diabetes established on insulin/metformin combination therapy. Diabetes Care 2002 25(10) 1685-90. [Pg.379]

Combining metformin with insulin therapy has been shown to result in less weight gain and better glycemic control with lower insulin requirements Continue combination oral agent therapy + sulfonylurea... [Pg.1358]

Jaber LA, Nowak SN, Slaughter RR Insulin-metformin combination therapy in obese patients with type 2 diabetes. J Clin Pharmacol 25 89-94, 2002. [Pg.1462]

Malone JK, Kerr LF, Campaigne BN, Sachson RA, Holcombe JH. Combined therapy with insulin lispro Mix 75/25 plus metformin or insulin glargine plus metformin a 16-week, randomized, open-label, crossover study in patients with type 2 diabetes beginning insulin therapy. Clin Ther 2004 26(12) 2034-2044. [Pg.63]

Kilo C, Mezitis N, Jain R, Mersey J, McGill J, Raskin P. Starting patients with type 2 diabetes on insulin therapy using once-daily injections of biphasic insulin aspart 70/30, biphasic human insulin 70/30, or NPH insulin in combination with metformin. J Diabetes Comphcat 2003 17(6) 307-313. [Pg.64]

More recently, metformin has been used successfully in different forms of anti-diabetic triple therapy [30-34], which are becoming more and more popular to avoid insulin therapy. In these smdies metformin was either combined with sulfonylureas and thiazolidendiones, or with sulfonylureas and Exenatide and in the end also with thiazolidendiones and insulin as proposed as the final step in the recently published ADA-EASD algorithm [22]. In a recent review [22] the triple therapy (metformin plus sulfonylurea plus thiazohdendione) was seen relatively critical. It should be considered only when patients are already close to target and when circumstances make it difficult to use insulin. Furthermore, the combination of three oral agents is more expensive than using insulin plus metformin, and no benefit has been shown. [Pg.81]

The patient who would benefit the most from a thi-azolidinedione is a type 11 diabetic with a substantial amount of insulin resistance (e.g., one who does not respond to other oral therapies or who requires excessive amounts of insulin [>100 units/day]). Improvements in diabetic control are variable, ranging from a 1% reduction in hemoglobin Ale when used as monotherapy to greater reductions (>2% reduction in hemoglobin Ale) when used in combinations with other agents, such as sulfonylureas or metformin. [Pg.774]

Diabetes mellitus, combination therapy PO With insulin Initially, 15-30 mg once a day. Initially, continue current insulin dosage then decrease insulin dosage by 10% to 25% if hypoglycemia occurs or plasma glucose level decreases to less than 100 mg/dl. Maximum 45 mg/day. With sulfonylureas Initially, 15-30 mg/day. Decrease sulfonylurea dosage if hypoglycemia occurs. With metformin Initially, 15-30 mg/day. As monotherapy Monotherapy is not to be used if patient is well controlled with diet and exercise alone. Initially, 15-30 mg/day. May increase dosage in increments until 45 mg/day is reached. [Pg.995]

Pramlintide is approved for concurrent mealtime administration in individuals with type 2 diabetes treated with insulin, metformin, or a sulfonylurea who are unable to achieve their postprandial glucose targets. Combination therapy results in a significant reduction in early postprandial glucose excursions mealtime insulin or sulfonylurea doses usually have to be reduced to prevent hypoglycemia. [Pg.946]

Insulin treatment in Type 2 diabetes. When oral therapy fails, insulin treatment should be used alone or in combination with metformin. There is little advantage from adding insulin to a sulphonylurea. The advent of thiazolidinediones offers an alternative to combining metformin with insulin, but more experience of these drugs is required before their combination with metformin can be routinely recommended. It is important to stop the thiazo-lidinedione, if not effective, before progressing to insulin. Definitive evidence that institution of insulin will reduce complications is lacking however, there is an improvement in quality of life, with few patients requesting to stop insulin once they have... [Pg.691]


See other pages where Insulin therapy metformin combination is mentioned: [Pg.647]    [Pg.168]    [Pg.754]    [Pg.141]    [Pg.303]    [Pg.419]    [Pg.61]    [Pg.80]    [Pg.103]    [Pg.107]    [Pg.646]    [Pg.125]    [Pg.657]    [Pg.508]    [Pg.542]    [Pg.278]    [Pg.397]    [Pg.756]    [Pg.943]    [Pg.944]    [Pg.369]    [Pg.436]    [Pg.1004]    [Pg.1006]    [Pg.201]    [Pg.264]    [Pg.125]   
See also in sourсe #XX -- [ Pg.141 , Pg.147 , Pg.150 ]




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