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The Safety and Use of Oral Methazolamide in Type 2 Diabetes

Methazolamide, a carbonic anhydrase inhibitor, is a medication used to treat increased pressure inside the eye due to glaucoma…. 

Methazolamide decreases the production of fluid inside the eye and, by lowering eye pressure, it helps prevent nerve damage, vision loss, and blindness.

In this study, researchers evaluated the safety and efficacy of methazolamide and sought to determine if it could be used as a treatment in type 2 diabetes.

They conducted a 24-week, double-blind, placebo-controlled study in which 76 patients were randomized to either oral methazolamide at a dose of 40 mg bid or placebo. The placebo-corrected reduction in HbA1c from baseline was measured at 24 weeks as the primary end point for methazolamide treatment.

The mean ± SD HbA1c from baseline to the primary end point was 7.1 ± 0.7% in the intervention group (n=37) and 7.4 ± 0.6% in the placebo group (n=39). Patients taking methazolamide achieved a change in HbA1c of –0.39% (95% CI –0.82, 0.04; p <0.05) and a rapid decrease in alanine aminotransferase by approximately 10 units/L. In addition, the proportion of patients in the intervention group who reported an HbA1c ≤6.5% increased from 8% to 33%. Patients who were receiving dual therapy with methazolamide and metformin experienced 2% weight loss.

Based on the results of the data, methazolamide was more efficacious than placebo at decreasing HbA1c in patients with type 2 diabetes. This medication is associated with many clinical benefits, and glycemic control seems to be one of them.

Practice Pearls:
  • Methazolamide is a carbonic anhydrase inhibitor typically used to decrease eye pressure, but is also beneficial in patients with type 2 diabetes.
  • This study indicated that methazolamide was more effective at reducing HbA1c, when compared to placebo.
  • Patients taking this drug also had a rapid decrease in alanine aminotransferase, and patients who were taking it with metformin experienced a small degree of weight loss.

Simpson RW, Nicholson GC, Proietto J, Sarah A, Sanders KM, Phillips G, Chambers J, MacGinley R, Orford N, Walder K, Krippner G, Skoff K, Wacher VJ. Efficacy and Safety of Oral Methazolamide in Patients With Type 2 Diabetes: A 24-Week, Placebo-Controlled, Double-Blind Study. Diabetes Care. 2014 Aug 14; pii: DC_141038 [Epub ahead of print].