Issue 141 Item 9 Rosiglitazone And Metformin Have Different Effects In Diabetics

Rosiglitazone and metformin monotherapy have different effects on adipose tissue distribution and glucose uptake in type 2 diabetics. Metformin improves glycamic control without increasing peripheral insulin sensitivity. Improved insulin sensitivity of non-abdominal subcutaneous adipose tissue with rosiglitazone partly explains enhanced whole-body insulin sensitivity, report researchers in Finland, and Sweden.

That improved insulin sensitivity, they say, underlies the central role of adipose tissue for the action of peroxisome proliferator-activated receptor gamma agonist in vivo.

The researchers evaluated the effects of twice daily doses of rosiglitazone 4.0 mg. and metformin 1.0 gram monotherapy for 26 weeks on adipose tissue insulin-stimulated glucose uptake in 41 type 2 diabetics.

Glucose uptake was measured and adipose tissue masses quantified before and after treatment.

Rosiglitazone improved insulin-stimulated whole-body glucose uptake by a statistically significant 44% compared with placebo. Mean body weight was unchanged in the rosiglitazone group, but fell by 2.0 kg. in patients on metformin.

In visceral adipose tissue, glucose uptake increased by 29% with rosiglitazone and by 17% in the metformin group. Visceral adipose tissue mass fell simultaneously with both treatments, so there was no change in total visceral glucose uptake per depot.

Rosiglitazone significantly raised glucose uptake in the femoral subcutaneous area, either when expressed per tissue mass or per whole-fat depot. Diabetes 2003; 52(2):283-290