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  • Targeting postprandial blood glucose concentrations reduced haemoglobin A1c concentrations in type 2 diabetes mellitus

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Therapeutics
Targeting postprandial blood glucose concentrations reduced haemoglobin A1c concentrations in type 2 diabetes mellitus

https://doi.org/10.1136/ebm.6.3.80

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    (2000) Diabetes Care 23, 1236. Bastyr EJ 3d, Stuart CA, Brodows RG, et al,. for the IOEZ Study Group.. Therapy focused on lowering postprandial glucose, not fasting glucose, may be superior for lowering HbA. 1c. . . Sep;. :. –41.
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 QUESTION: What is the comparative efficacy and safety of treatment strategies that target either fasting, premeal, or postprandial glucose concentrations in patients with type 2 diabetes mellitus that was not adequately controlled with sulfonylurea agents alone?

    Design

    Randomised {allocation concealed*}†, unblinded,* controlled trial with 3 months of follow up.

    Setting

    22 centres in the US.

    Patients

    135 patients (mean age 57 y, 60% men) with type 2 diabetes who had secondary sulfonylurea failure defined as initial stabilisation of glucose control for ≥6 months and a subsequent lack of glucose control using maximal sulfonylurea doses. 114 patients (84%) had complete follow up.

    Intervention

    Patients were allocated to 1 of 3 groups for 3 months: insulin lispro plus glyburide (L plus G group, n=41), which targeted postprandial blood glucose concentrations; metformin plus glyburide (M plus G group, …

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    Footnotes

    • Source of funding: no external funding.

    • For correspondence: Dr E J Bastyr III, Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN 46285, USA. Fax +1 317 277 1234.

    • ↵* See glossary.

    • ↵† Information provided by author.