USE OF AN ALPHA-GLUCOSIDASE INHIBITOR TO SYNCHRONIZE SUGAR ABSORPTIONWITH DELAYED INSULIN-SECRETION IN A PATIENT WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

The case of a 67-year-old women with non-insulin-dependent diabetes me llitus is described. Diabetes was first diagnosed when the woman was a ged 55; a diet of 1440 kcal daily was recommended and 500 mg tolbutami de daily was prescribed. Hypoglycaemia was improved for a while but th e blood-sugar concentration gradually increased until a tolbutamide do se of 2000 mg/day was needed, The patient eventually came to an out-pa tient clinic for diabetes control due to continuous hyperglycaemia. He r diabetes proved difficult to control, probably due, in part, to exce ssive eating and lack of exercise, despite appropriate education and g libenclamide treatment. After 15 months, an alpha-glycosidase inhibito r, at a dosage of 0.75 mg/day, was added to the treatment with glibenc lamide at 7.5 mg/day and the glycosylated haemoglobin level was reduce d to normal levels within 2 months. After a further 6 months the glibe nclamide dose was reduced to 3.75 mg/day with no ill effects during th e subsequent 4 weeks, up to the present day.