Objective. The aim of this study wasto compare the clinical effects of a tripleoral antidiabetic combination versus basalinsulin and metformin combinationtreatment in patients with poorly controlledtype 2 diabetes.Methods. Eighty patients with type 2diabetes, who were treated by metforminand sulphonylurea combination, and hadHbA1c values between 7.5 and 10 % (58and 86 mmol/L), were randomized into twogroups. The first group was given triple oralantidiabetic therapy (pioglitazone,metformin, and sulphonylurea) and thesecond group was given metformin and abedtime basal insulin (insulin detemir)combination for 12 weeks. Metabolicparameters were evaluated.Results. The mean fasting plasmaglucose and HbA1c levels decreased in bothgroups. The decrease in HbA1c was slightlyhigher in triple oral antidiabetic group(p=0.046). The patients in triple oralcombination group gained 0.2 kg (p=0.881)and those in the metformin-insulin detemircombination group lost 1.7 kg (p=0.001) in12 weeks (p=0.29 between groups). Thefrequency of hypoglycemia was higher intriple oral antidiabetic group (11 vs. 2episodes, respectively).Conclusion. Both sulphonyureametformin-pioglitazone and insulindetemir-metformin therapies providedsignificant improvements in glycemiccontrol. However, sulphonylurea,pioglitazone and metformin combinationled to more frequent hypoglycemic events,and weight management seemed in favor ofinsulin detemir-metformin combination.

Introduction. Our aim was to compare the effects of conventional diabetic diet with refined carbohydrate restricted diet on glycemic and metabolic parameters in type 2 diabetic patients who were treated by insulin.