THE EFFECT OF A VERY-LOW DOSE OF TOLBUTAMIDE COMBINED WITH AN ALPHA-GLUCOSIDASE INHIBITOR IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS

The effect of adding a very low dose of a sulphonylurea (tolbutamide) to the treatment of 10 patients with noninsulin-dependent diabetes mel litus (NIDDM) was investigated. Patients took 0.1 mg tds of an alpha-g lucosidase inhibitor orally for 8 weeks, and 50 mg tds of the sulphony lurea, tolbutamide, for the last 4 weeks of this period. The glycosyla ted haemoglobin level was significantly reduced during the combined tr eatment period compared with the level after treatment with alpha-gluc osidase inhibitor alone (P = 0.035), although not compared with the pr etreatment level. There were no significant changes in post-prandial b lood glucose, serum lipid levels or connective peptide immunoreactivit ies. These preliminary results indicate that the addition of a very lo w dose of tolbutamide to a recommended diet and treatment with an alph a-glucosidase inhibitor, may improve glucose metabolism without raisin g insulin secretion or influencing lipid metabolism.