Issue 157 Item 12 Repaglinide + Metformin Vs. Nateglinide + Metformin in Treatin

Patients with type 2 diabetes have significantly better fasting plasma glucose levels (FPG) and hemoglobin A1c (HbA1c) levels when treated with metformin combined with repaglinide rather than combined with nateglinide. Philip Raskin, MD, professor of internal medicine, University of Texas Southwestern at Dallas, Tex, presented these findings here on May 16th during the American Association of Clinical Endocrinologists 12th Annual Meeting and Clinical Congress.

The parallel group, randomized, open-label trial, compared the efficacy and safety of repaglinide and nateglinide in combination with metformin for 16 weeks. The group enrolled 192 type 2 diabetic patients with mean ages of 55.9 and 45.3 respectively.

Mean change from baseline HbA1c in the repaglinide patients was –1.28 (P<0.001), almost double the –0.67 (P<0.001) mean change in the nateglinide group. FPG baseline mean for the repaglinide group was 189 compared to 191 for the nateglinide group. The mean change from those baselines was –31 for the repaglinide group compared to –21 for the nateglinide group. “This research may help clinicians decide which of these short acting nonsulfonylurea secretagogues to use in combination with metformin after failure of single oral-agent monotherapy,” said Dr. Raskin. This study was financed by Novo Nordisk Pharmaceuticals, Inc., Princeton, N.J. [Study title: Efficacy and Safety of Combination Therapy: Repaglinide Plus Metformin Versus Nateglinide Plus Metformin. Abstract 46]