Repaglinide/Bedtime NPH Insulin Is Comparable to Twice-Daily NPH Insulin
- Araceli Panelo, MD, MSC1,
- Jeffrey Robert Wing, MD, FRCP2 and
- for the AGEE-1272 Study Group*
- 1Department of Medicine, Amang Rodriguez Medical Centre, Marikina City, Philippines
- 2Department of Medicine, Johannesburg Hospital, Johannesburg, South Africa
- Address correspondence and reprint requests to Dr. Araceli Panelo, Department of Medicine, Amang Rodriguez Medical Centre, Marikina City, 1800, Philippines. E-mail: aapanelo{at}yahoo.com
The combination of oral antidiabetic drugs and bedtime insulin is currently regarded as the first-line therapy in type 2 diabetes. Repaglinide is an insulin secretatogue with a rapid onset and relatively short duration of action (1–3) that was developed for prandial glucose regulation. The prandial glucose regulation strategy attempts to synchronize availability of insulin to the physiological need by stimulating endogenous insulin output in line with glucose intake. In type 2 diabetes, flexible prandial glucose regulation with repaglinide is well tolerated and safe, irrespective of the number of meals consumed per day (4,5). Repaglinide/NPH insulin combination has shown improved glycemic control in type 2 diabetic subjects inadequately controlled by sulfonylureas alone or in combination with metformin (6) or insulin monotherapy (7). However, no direct comparison between repaglinide and NPH insulin combination with NPH twice daily in type 2 diabetic subjects has been reported.
RESEARCH DESIGN AND METHODS
This trial was conducted in 12 sites in Southeast Asia and South Africa. Inclusion criteria included having type 2 diabetes, age ≥18 years, BMI ≤35 kg/m2, HbA1c (A1C) ≥7.5 and ≤13%, previous treatment with sulfonylurea and/or metformin therapy for at least 3 months before study onset (for subjects on sulfonylurea and metformin therapy, metformin dose …
