Treatment of Type I Diabetes with a Combination of Glyburide and Insulin

OBJECTIVE:To assess the ability of a combination of insulin and an oral hypoglycemic agent (glyburide) to improve the overall glycemic control in a population of patients with type I diabetes.DESIGN:Randomized, placebo-controlled, double-blind trial.SETTING:Community-based, university-affiliated, family medicine group.PATIENTS:Men and women between 18 and 68 years of age with type I diabetes.INTERVENTIONS:Subjects were observed and titrated on an insulin only regimen for 12 weeks (phase I). Subjects were then randomized to receive either placebo or glyburide 10 mg/d for an additional 12 weeks (phase II).MAIN OUTCOME MEASURES:Glucose measurements were taken at breakfast, lunch, supper, and bedtime. Each patient also was followed sequentially for serum lipids, glycosylated hemoglobin, (Hb A1c) and daily insulin utilization.RESULTS:Average fasting blood glucose (FBG) measurements were significantly lower in the glyburide-treated group during phase II (9.22 ± 0.55 mmol/L) compared with baseline (10.27 ± 0.93 ...