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| |  Oral Combination Therapy Controls Type II Diabetes Better than Insulin BIRMINGHAM, Ala., June 9, 1996 -- A University of Alabama at Birmingham (UAB) study shows that a large proportion of people with insulin-treated non-insulin-dependent diabetes mellitus (NIDDM or type II) can be successfully removed from insulin treatment and reintroduced to oral diabetic therapy if they are prescribed metformin and a sulfonylurea in combination. In addition, patients reintroduced to oral therapy also were better able to control their blood glucose levels than with insulin therapy. Titled, "Outcome of Metformin Facilitated Reinitiation of Oral Diabetic Therapy in the Insulin-Requiring Non-Insulin-Dependent Diabetic Patient," the study was presented today at the American Diabetes Association's 56th Scientific Sessions in San Francisco. Study authors David S.H. Bell, M.B., F.A.C.P., Professor of Medicine and Director of the UAB Endocrinology Clinic and Matthew S. Mayo, Ph.D., Research Assistant Professor, UAB Division of Hematology/Oncology, initially undertook the study because they hypothesized that many NIDDM patients had been placed on insulin therapy due to the unavailability of metformin therapy in the United States. "The United States uses more insulin than any other country," said Dr. Bell. "Until metformin became available a few years ago, physicians had no other choice except insulin once sulfonylurea therapy failed. If metformin had been available, it's likely that many patients would not have started on insulin therapy. "We were pleasantly surprised that so many in the study responded to this therapy and that it actually enabled them to better control their blood glucose levels. There's no question that the findings mean that a large number of NIDDM patients can treat their diabetes without the pain of injections." A total of 55 NIDDM patients who were using twice-daily mixed insulin injections to control their blood glucose level were recruited and identified to participate in the study. Each patient had been diagnosed for less than 30 years and on insulin therapy for less than 10 years. The study also concluded that patient conversion from insulin to oral combination therapy is most successful in patients with a short duration of NIDDM, lower body weight and lower insulin requirements. Patients who were successfully switched exhibited significantly lower glycosylated hemoglobin levels on the combination oral therapy than on insulin therapy. Overall reinitiation was successful in 76 percent of the study patients. Metformin, trade name Glucophage(R), an oral medication that belongs to a class of drugs called biguanides, was approved for marketing in the United States by the Food and Drug Administration on March 1, 1995. Metformin helps control type II diabetes, a condition where blood sugar levels are too high. It works by allowing the body to better use the insulin it already produces. Sulfonylurea drugs are oral antidiabetic agents that work by stimulating insulin production. Diabetes affects an estimated 16 million people in the United States, including a disproportionate number of minority populations; about 7 percent of the U.S. adult population has type II diabetes. Type II diabetes is the second leading cause of visits to physicians and the fourth leading cause of death by disease in this country. The disease is responsible for an estimated $100 billion annually in direct and indirect health care costs, amounting to approximately 12 percent of total annual U.S. health care expenditures. UAB is a comprehensive urban university with 15,500 students. Its medical center is recognized as among the nation's most productive. The Department of Medicine, for example, ranks eighth in the nation in NIH grant awards. UAB currently has approximately $200 million in active contracts and grants.
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