Combined with bedtime NPH insulin, metformin provides superior glycemic control to repaglinide. The study comapred the effect on glycemic control and weight gain of repaglinide versus metformin combined with bedtime NPH insulin in patients with type 2 diabetes.
A total of 80 subjects treated with 850 or 1,000 mg t.i.d. metformin combined with bedtime NPH insulin were randomized to 13 weeks of open-label treatment with 4 mg t.i.d. repaglinide (n = 39) or metformin (dose unchanged) (n = 41). Insulin dose was titrated at the clinician’s discretion, aiming for a fasting blood glucose (FBG) 6.0 mmol/l.
The study shoed that baseline age, diabetes duration, insulin requirement, weight, BMI, FBG, and HbA1c (Diabetes Control and Complications Trial–aligned assay, normal range 4.6–6.2%) were similar. Glycemic control improved (nonsignificantly) with insulin/metformin by (mean) 0.4%, from 8.4 to 8.1% but deteriorated with insulin/repaglinide by (mean) 0.4%, from 8.1 to 8.6%. Weight gain was less with insulin/metformin: 0.9 ± 0.4 kg (means ± SE) versus 2.7 ± 0.4 kg (P < 0.0001).
From the results, it was concluded that, combined with bedtime NPH insulin, metformin provides superior glycemic control to repaglinide with less weight gain and improved diabetes treatment satisfaction. Diabetes Care 25:1685-1690, 2002