HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Furlong, N. J. Articles by Hardy, K. J. Search for Related Content PubMed PubMed Citation Articles by Furlong, N. J. Articles by Hardy, K. J. Social Bookmarking                What's this?

Repaglinide Versus Metformin in Combination With Bedtime NPH Insulin in Patients With Type 2 Diabetes Established on Insulin/Metformin Combination Therapy

From the Diabetes Centre, Whiston Hospital, Prescot, Merseyside, U.K.

OBJECTIVE—To compare the effect on glycemic control and weight gain of repaglinide versus metformin combined with bedtime NPH insulin in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS—A total of 80 subjects treated with 850 or 1,000 mg t.i.d. metformin combined with bedtime NPH insulin were randomized to 13 weeks of open-label treatment with 4 mg t.i.d. repaglinide (n = 39) or metformin (dose unchanged) (n = 41). Insulin dose was titrated at the clinician’s discretion, aiming for a fasting blood glucose (FBG) 6.0 mmol/l.

RESULTS—Baseline age, diabetes duration, insulin requirement, weight, BMI, FBG, and HbA_1c (Diabetes Control and Complications Trial–aligned assay, normal range 4.6–6.2%) were similar. Glycemic control improved (nonsignificantly) with insulin/metformin by (mean) 0.4%, from 8.4 to 8.1% (P = 0.09) but deteriorated with insulin/repaglinide by (mean) 0.4%, from 8.1 to 8.6% (P = 0.03; P = 0.005 between groups). Weight gain was less with insulin/metformin: 0.9 ± 0.4 kg (means ± SE) (P = 0.01) versus 2.7 ± 0.4 kg (P < 0.0001) (P = 0.002 between groups). The Diabetes Treatment Satisfaction Questionnaire score (potential range 0 [minimum] to 36 [maximum]) increased from 32.4 ± 0.8 to 34.1 ± 0.5 (P = 0.01) with insulin/metformin but decreased from 32.5 ± 0.9 to 29.1 ± 1.3 (P < 0.002) with insulin/repaglinide.

CONCLUSIONS—Combined with bedtime NPH insulin, metformin provides superior glycemic control to repaglinide with less weight gain and improved diabetes treatment satisfaction.

Abbreviations: DTSQ, Diabetes Treatment Satisfaction Questionnaire • FBG, fasting blood glucose • WBQ, Well-Being Questionnaire

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. S Lund, L. Tarnow, M. Frandsen, U. M Smidt, O. Pedersen, H.-H. Parving, and A. A Vaag Impact of metformin versus the prandial insulin secretagogue, repaglinide, on fasting and postprandial glucose and lipid responses in non-obese patients with type 2 diabetes Eur. J. Endocrinol., January 1, 2008; 158(1): 35 - 46. [Abstract] [Full Text] [PDF]

				M. Malone Medications Associated with Weight Gain Ann. Pharmacother., December 1, 2005; 39(12): 2046 - 2054. [Abstract] [Full Text] [PDF]

				J. Burke Review: Combination treatment with insulin and oral agents in type 2 diabetes mellitus The British Journal of Diabetes & Vascular Disease, March 1, 2004; 4(2): 71 - 76. [Abstract] [PDF]