Abstract | INTRODUCTION: AIM: The aim of this study was to investigate whether a regimen free of long-acting insulin can provide long-term glycaemic control without causing weight gain. PATIENTS AND METHODS: This is an uncontrolled, 1-year study comprising 58 patients with type 2 diabetes and secondary failure, age 30-75 years, BMI 25-35 kg/m(2), HbA1c > 7.5% and fasting C-peptide level > 0.3 mmol/l. All patients were treated with the GAME regimen, a combination of glimepiride administered at 20:00 hours for nocturnal glycaemic control, insulin aspart three times daily for meal-related glucose control and metformin. RESULTS: Seventy-one per cent of the patients were considered evaluable. HbA1c decreased from 10.0 +/- 0.3 to 7.4 +/- 0.1% (p < 0.001). Fifty-nine per cent reached HbA1c levels <or= 7.5%. Symptomatic nocturnal hypoglycaemia was not reported. Body weight tended to decrease during the first 3 months (-1.0 +/- 0.5 kg, p = 0.06), but then gradually rose to a value 0.8 +/- 0.5 kg higher than at baseline (p = 0.12). This is 4.4 +/- 0.6 kg less than predicted for conventional regimens employing long-acting insulin (p < 0.001). CONCLUSION: The GAME regimen provides long-term glycaemic control as well as stabilization of body weight in about 60% of type 2 patients presenting with secondary failure.
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Authors | H de Boer, R Keizers, M Jansen, L Verschoor, J Ruineman-Koerts |
Journal | Diabetes, obesity & metabolism
(Diabetes Obes Metab)
Vol. 8
Issue 5
Pg. 517-23
(Sep 2006)
ISSN: 1462-8902 [Print] England |
PMID | 16918586
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Blood Glucose
- Glycated Hemoglobin A
- Hemoglobins
- Hypoglycemic Agents
- Insulin
- Sulfonylurea Compounds
- hemoglobin A1c protein, human
- glimepiride
- Metformin
- Insulin Aspart
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Topics |
- Adult
- Aged
- Blood Glucose
(metabolism)
- Body Mass Index
- Diabetes Mellitus, Type 2
(blood, drug therapy, physiopathology)
- Drug Therapy, Combination
- Female
- Glycated Hemoglobin
- Hemoglobins
(metabolism)
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Insulin
(analogs & derivatives, therapeutic use)
- Insulin Aspart
- Male
- Metformin
(therapeutic use)
- Middle Aged
- Sulfonylurea Compounds
(therapeutic use)
- Treatment Failure
- Treatment Outcome
- Weight Gain
(drug effects)
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