Resumen
Tras la evidencia presentada por el Diabetes Control and Complications Trial y el UK Prospective Diabetes Study, en el sentido de que el control intensivo de la glucemia puede reducir de manera significativa el riesgo de enfermedad microvascular, se recomiendan objetivos estrictos para dicho control. El agregado temprano de insulina basal al tratamiento con sulfonilurea de pacientes con diabetes tipo 2 demostró ser eficaz en relación con el logro de un buen control glucémico, a la vez que limita la aparición de hipoglucemia y la ganancia de peso. Esta adición precoz de insulina a los agentes orales es un enfoque importante para lograr los objetivos recomendados actualmente sobre el estricto control de la glucemia. La elaboración de nuevos tipos de insulina que permiten un mejor control diurno de la glucemia y que requieren menos inyecciones diarias puede hacer que esta politerapia sea más aceptable para el paciente. Junto con la necesidad de mantener niveles estrictos de HbA1c para evitar o retardar la aparición de complicaciones diabéticas, puede que la politerapia deba ser la norma para pacientes con diabetes tipo 2.
Palabras clave
Diabetes tipo 2, politerapia, sulfonilurea, insulina.
Clasificación en siicsalud
Artículos originales> Expertos del Mundo>
página www.siicsalud.com/des/des037/04503002.htm
Especialidades
Principal: Endocrinología y Metabolismo
Relacionadas: Bioquímica, Farmacología, Medicina Farmacéutica, Nutrición, Atención Primaria, Medicina Interna
Patrocinio y reconocimiento
La investigación se llevó a cabo en Radcliffe Infirmary, Oxford, University Hospitals of Leicester, Torbay Hospital, Torquay, Peterborough General Hospital, Scarborough Hospital, Derbishire Royal Infirmary, Manchester Royal Infirmary, Hope Hospital, Salford and the Royal Devon & Exeter Hospital, Exeter. Fue muy estimada la cooperación de los pacientes y del personal del NHS y no NHS en los centros. Las principales subvenciones para este estudio provinieron del UK Medical Research Council, British Diabetic Association, el UK Department of Health, The Nacional Eye Institute y The Nacional Institute of Digestive, Diabetes and Kidney Disease in the Nacional Institutes of Health, USA, The British Heart Foundation, Novo-Nordisk, Bayer, Bristol Myers Squibb, Hoechst, Lilly, Lipha and Farmitalia Carlo Erba. La lista de las otras compañías y agencias auspiciantes, los comités de supervisión, y el personal participante fueron mencionados en una publicación previa.
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Sulphonylurea combined with insulin improves glycaemic control in type 2 diabetes
Abstract
Strict glycaemic control targets have been recommended following evidence from the Diabetes Control and Complications Trial and UK Prospective Diabetes Study that intensive glycaemic control can significantly reduce the risk of microvascular disease. Addition of basal insulin to sulphonylurea therapy early in the progress of Type 2 diabetes has been shown to be beneficial in relation to achieving good glycaemic control, whilst limiting the occurrence hypoglycaemia and weight gain. This early addition of insulin to oral agents is an important approach to achieving currently recommended strict glycaemic control targets. The development of newer insulin types which allow better diurnal control of glycaemia and require fewer daily injections may make this combination therapy more acceptable to the patients. With the need for maintaining strict target levels of HbA1c, in order to prevent or delay the onset of diabetic complications, combination therapies may need to become the norm for patients with Type 2 diabetes.
Key words
type 2 diabetes, combination therapy, sulphonylurea, insulin
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Bibliografía del artículo
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