Combination Therapy Improves Management of Obese
Diabetics
Adding rosiglitazone, to metformin, greatly enhances
the management of obese type 2 diabetic patients
who are inadequately controlled by metformin alone.
The combination
improves glycemic control, insulin sensitivity
and beta-cell function to "a clinically
important extent", say researchers at GlaxoSmithKline,
Collegeville, Pennsylvania and in Harlow, Essex,
England, and endocrinologists in Antwerp, Belgium.
They evaluated the efficacy of rosiglitazone when
added to the therapy of obese diabetics taking near-maximum
metformin doses of 2.5 grams daily.
The researchers reasoned that adding an agent, such
as rosiglitazone, which reduced insulin resistance
to the treatment of obese, insulin-resistant diabetics
who were inadequately controlled by metformin might
be a more rational approach than adding an insulin
secretagogue.
Data involving 550 type 2 diabetics were pooled
from two double-blind studies of rosiglitazone added
to metformin 2.5 grams daily.
Patients
were categorised according to their index baseline
body mass as non-overweight (<25 kgm-2),
overweight (25-30 kgm-2, ) and obese (>30 kgm-2).
Rosiglitazone significantly improved glycemia (HbA1c)
and fasting plasma glucose in all three groups. The
greatest effect was in the obese patients.
Improvements in Homeostasis Model Assessment estimates
of insulin resistance, beta-cell function and reductions
in fasting insulin were also greatest in obese patients.
Adverse events did not demonstrably differ between
obese and non-obese patients.
Diabetes, Obesity & Metabolism 2003;5:3:163-170
===========================
DID YOU KNOW: A recent article reported that patients
with diabetes are 1.6 times more likely than patients
without diabetes to use complementary and alternative
medicines. Recent surveys of patients treated in
diabetes clinics indicate that 17-31% use complementary
products.
Jama 280:1569-1575 1998, Pract Diabetes Int 14:207-214,
1997
