RÉSUMÉ
This study reports a follow up of 29 Type II Diabetic patients with secondary drug failure treated by a combination of Human Insulin and Glipizide. During their follow-up, Insulin therapy was instituted following discontinuation of the maximum permissible dose of sulphonylureas for variable periods of time and thereafter Glipizide was added to Insulin treatment. Their diabetic control was assessed by checking the fasting and 2hr postprandial venous blood glucose values, HbA[1c] and weight changes. These results were then compared in various phases of treatment, i.e. Phase I: Oral hypoglycemic agents, Phase II: Insulin alone [mean duration 2.55 +/- 1.75 years], and Phase III: Human Insulin and Glipizide combination [mean duration 1.93 +/- 0.72 years]. It was found that patients in Phase III showed an overall improved glycemic control compared to Phase I and II. HbA1c dropped to 9.11 +/- 3.25 in Phase III compared to 11.13 +/- 2.75 in Phase II and 11.45 +/- 2.07 in Phase I. There was a weight gain of 3.66 +/- 6.69 kg in Phase II as compared to a net loss of 1.14 +/- 5.93 kg in Phase III. The mean daily requirement of Insulin in Phase II of 65.19 U decreased to 49.62 U in Phase III.No relationship was established between the initial high Body Mass Index and initial C-peptides of responders and non-responders to combination therapy. This study highlights the value of combination therapy of Glipizide plus Human Insulin in the control of diabetes after secondary failure in Type II diabetic patients