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Addition of rosiglitazone to metformin is most effective in obese, insulin‐resistant patients with type 2 diabetes
Author(s) -
Jones T. A.,
Sautter M.,
Van Gaal L. F.,
Jones N. P.
Publication year - 2003
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1046/j.1463-1326.2003.00258.x
Subject(s) - rosiglitazone , metformin , type 2 diabetes , medicine , insulin , diabetes mellitus , insulin resistance , endocrinology
Aim: These analyses were undertaken to evaluate the efficacy of the insulin sensitizer rosiglitazone (RSG) when added to the therapy of obese type 2 diabetes mellitus patients (T2D M ) taking near‐maximal doses (2.5 g/day) of metformin (MET). In obese, insulin‐resistant patients with T2D M who are inadequately controlled on MET, the addition of an agent that reduces insulin resistance may be a more rational and innovative approach than the addition of an insulin secretagogue. Methods: Data were pooled from two double‐blind studies of RSG added to 2.5 g/day MET, involving a total of 550 T2D M patients. Patients were categorized as non‐overweight, overweight and obese according to their baseline BMI using WHO criteria (<25 kgm −2 , 25–30 kgm −2 , >30 kgm −2 respectively). Results: RSG improved glycaemia (HbA1c) and fasting plasma glucose (FPG) to a clinically significant extent in all three subgroups but the effect was most pronounced in the obese patients. Improvements in HOMA estimates of insulin resistance and beta‐cell function were also greatest in the obese patients (4 mg: −16% and +19%; 8 mg: −37% and + 33% respectively), as were reductions in fasting insulin. The profile of adverse events was not demonstrably different in obese patients from the non‐obese. Conclusions: In obese type 2 diabetic patients inadequately controlled on MET alone, addition of rosiglitazone improves glycaemic control, insulin sensitivity and beta‐cell function to a clinically important extent.