BACKGROUND: Recently, the usefulness of metformin as an oral hypoglycemic agent has been re-evaluated, while secondary failure of long-term treatment with sulfonylurea (SU) has become a serious problem. In this study, the usefulness of combination therapy with metformin was evaluated in patient with non-obese type 2 diabetes mellitus showing secondary failure of treatment with SU.
PATIENTS AND METHODS: Twenty non-obese patients with type 2 diabetes mellitus showed HbA_1c levels of 7% or over despite more than 5 years of treatment with SU. Metformin was administered to these patients at a dose of 500 mg/day for 3 months in combination with SU, and glycemic control was compared before and after combination therapy.
RESULTS: After combination therapy, the mean plasma glucose level obtained 2 hours postprandial was significantly decreased by 20.0% (216±41.7 mg/dl vs. 172.0±47.7 mg/dl, p<0.001) . In addition, the mean HbA_1c level was significantly decreased by 8.8% (8.0±0.8% vs. 7.3±0.8%, p<0.001) . However, the mean IRI level, the mean body mass index, and mean plasma lipid levels did not significantly change after combination therapy.
CONCLUSIONS: These findings suggest that combination therapy with metformin is useful for improving blood glucose levels without enhancing insulin secretion in patients with non-obese type 2 diabetes mellitus who showed secondary failure of treatment with SU. However, further studies are needed to confirm whether this combination therapy will contribute to delaying the introduction of insulin therapy.

The purpose of this study was to examine effects of moderate-intensity endurance exercise on reactive oxygen species production and leukocyte activation markers in young and middle-aged persons. Blood samples were collected before and after the jogging of 10 km. Although cytokines recruiting and priming neutrophils and monocytes were released into the circulation and functional after the jogging of 10 km, reactive oxygen metabolites-derived compounds (d-ROMs) were not significantly increased. It was indicated that chemokines and leukocyte activation markers at rest were increased with aging, and that might be accompanied by the higher level of d-ROMs in the elderly.

Athletes have been instructed to refrain from taking carbonated beverages in the sports world, but the mechanism has not been clear. The purpose of this study was to clarify how physiological and biochemical evaluation are affected by taking a 10% CHO carbonated beverage after cycle ergometer (60 min, 60% VO₂max). Seven subjects consumed a carbonated or noncarbonated (10% carbohydrate) beverage after exercise. No differences were observed in concentration of glucose, insulin, free fatty acids, K and Na in serum from carbonated beverage compared with noncarbonated beverage intakes after exercise.These results indicate that carbonated beverage did not affect the changes of physiological and biochemical parameter after prolonged exercise, and it could be more refreshing and stimulate taste rather than noncarbonated beverage, but seemed to be hard to drink immediately after exercise because it made subjects feel as if having drunk more than they did.