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The Combined Effect of Triple Therapy with Rosiglitazone, Metformin, and Insulin Aspart in Type 2 Diabetic Patients

Response to Davidson and Mikhail

From the Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense C, Denmark

Address correspondence to Dr. Henning Beck-Nielsen, Odense University Hospital, Department of Endocrinology, Kloevervaenget 6,4, 5000 Odense C, Denmark. E-mail: henning.beck-nielsen@ouh.fyns-amt.dk

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We were not able to normalize HbA_1c values completely during triple therapy probably due to the fact that insulin action was not completely normalized by rosiglitazone and metformin, as stated by Davidson (1). Still, insulin-mediated glucose uptake was only 60% normal during triple therapy; however, a longer treatment period or a more potent insulin synthesizer may help in that respect. Another way to further reduce HbA_1c values is to use a more aggressive algorithm, increasing the Novorapid dose further before meals. However, this may induce more hypoglycemic attacks during the day time. . . . [Full Text of this Article]

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