Two drugs combined with insulin are better than one in regulating the blood-sugar levels of type 2 diabetics without the common side effect of weight gain, according to a study reported in the July issue of Diabetes Care.
Type 2 diabetics being treated with drugs typically take insulin and only one of the drugs. Such patients often lower their blood sugar below the 7 percent limit suggested by the American Diabetes Association, but they also tend to gain weight and to increase their insulin doses.
University of Texas Southwestern Medical Center researchers say they are the first to analyze the safety and effectiveness of triple therapy using insulin, metformin and a drug in the thiazolidinedione family.
"We've shown spectacular control of blood sugar levels in the absence of weight gain, a common side effect of drug therapies for type 2 diabetes," said study author Dr. Philip Raskin, a UT Southwestern professor of internal medicine. "And we can keep the blood sugar under control with relative ease. This is a step in the right direction for effectively treating type 2 diabetes."
In the UT Southwestern study, all 28 patients who used triple therapy reduced their blood-sugar levels below 7 percent without increasing insulin. Patients who took the therapy in a particular order, with the thiazolidinedione administered after a period of insulin and metformin use, actually showed a slight decrease in weight, along with lowering blood sugar.
Almost 60 percent of all patients, regardless of what order the drugs were taken, reduced blood sugar levels below 6 percent.
Keeping blood-sugar levels under 6 percent or 7 percent significantly reduces the risk of eye disease, kidney disease and amputations, said lead researcher Suzanne Strowig, a UT Southwestern faculty member.
Drugs like metformin and those in the thiazolidinedione family help the body regulate the amount of glucose in the blood and decrease the amount of glucose made by the liver. They also help the body more effectively use its own insulin, according to the researchers.
"With many of these drugs, though, people have been unable to control their weight," Raskin said. "But put together, especially in a particular order, they show the most promise.
