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Volume 348:760-761 February 20, 2003 Number 8
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Initial Management of Glycemia in Type 2 Diabetes

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by Nathan, D. M.
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To the Editor: In his Clinical Practice article (Oct. 24 issue),1 Nathan states that "although combination therapy with a sulfonylurea (or glitinides) and insulin has been approved for use, I do not recommend it." The author bases his recommendation on the principle that combination therapy should involve agents with different primary modes of action, but often we use agents with the same mode of action but different pharmacokinetic profiles — a clear example being insulin mixtures.

In most patients with type 2 diabetes, sulfonylureas can be viewed as an "endogenous insulin injection." That being the case, the combination of a . . . [Full Text of this Article]



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