RESUMO
INTRODUCTION: Weight gain appears to be unavoidable in patients with type 2 diabetes who are switched from oral agents to insulin therapy. Peripheral hyperinsulinism induced by the use of long-acting insulin may be the key to explain this adverse effect. 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 Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico
, Hipoglicemiantes/uso terapêutico
, Insulina/análogos & derivados
, Aumento de Peso/efeitos dos fármacos
, Adulto
, Idoso
, Glicemia/metabolismo
, Índice de Massa Corporal
, Diabetes Mellitus Tipo 2/sangue
, Diabetes Mellitus Tipo 2/fisiopatologia
, Quimioterapia Combinada
, Feminino
, Hemoglobinas Glicadas
, Hemoglobinas/metabolismo
, Humanos
, Insulina/uso terapêutico
, Insulina Aspart
, Masculino
, Metformina/uso terapêutico
, Pessoa de Meia-Idade
, Compostos de Sulfonilureia/uso terapêutico
, Falha de Tratamento
, Resultado do Tratamento