Eighteen-month follow-up of glipizide and human insulin combination in the treatment of type II diabetes mellitus

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

pattern of complications in Saudi Arabian diabetics

The pattern of complications in 533 Saudi Arabian diabetics followed over a 2-year period at King Abdulaziz University Hospital, Jeddah, is reported. The subjects consisted of 137 type 1 [25.7%] and 396 type 2 diabetics [74.3%]. For type 1, the mean age was 32.1 +/- 1.1 years, and the mean duration of the disease was 7.4 +/- 0.5 years. Diabetic ketoacidosis occurred in 37.2% of subjects. Peripheral neuropathy affected 28.5%, retinopathy 13.1%, nephropathy 18.2%, and macrovascular complications 10.2% of the type 1 group. For type 2, the mean age for the group was 46.5 +/- 0.6 years, and the mean duration of the disease was 4.5 +/- 0.3 years. Peripheral neuropathy affected 23.7%, retinopathy 8.3%, nephropathy 11.4%, and macrovascular complications 11.1% of type 2 subjects

Diabetic ketoacidosis - a report of 123 Saudi diabetics

Diabetic ketoacidosis [DKA] still forms one of the potentially fatal complications of IDDM diabetes. In a study of 123 consecutive admissions to King Abdulaziz University Hospital Medical Ward, with an age range of 15-80 years, poor compliance was the most frequent predisposing factor accounting for 65.9% of admissions. The mean blood glucose on admission was 26.2 +/- 0.12 mmol/1 and mean pH was 7.22 +/- 0.24. An insulin regimen of continuous low dose i.v. infusion was used in 43.1%, hourly i.v., hourly i.v., bolus in 34.1% and hourly i.m. in 22.8% of all subjects. The mean total fluid replacement in the first 5 h was 3.3 +/- 0.11. Mortality was 4.3% in the group. All three modalities of therapy were equally effective