In a study conducted in Finland, it was discovered that insulin combined with metformin (Glucophage) taken at bedtime appears to be an effective regimen for controlling type 2 diabetes.
The results of the study were published in the March 2 issue of the Annals of Internal Medicine. Finnish investigators report the results of a direct comparison of four bedtime insulin regimens that were randomly assigned to 96 patient with type 2 diabetes. The patients had previously been treated by sulfonylurea therapy alone, and had demonstrated an average HbA1c of 9.9 % and an average BG reading of 214.5 mg/dl.
For 12 months, the 96 patients took a combination of either: (1) bedtime intermediate-acting insulin plus glyburide (10.5 mg.) and placebo, (2) metformin (2 grams) and placebo, (3) glyburide and metformin, or (4) a second injection of intermediate-acting insulin in the morning.
After 13 months, the group taking the combination of intermediate-acting insulin and metformin demonstrated the greatest decrease in HbA1c (9.7 % to 7.2 %). Additionally, this group reported fewer cases of hypoglycemia after one year when compared to the other groups.