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Effect of repaglinide addition to metformin monotherapy on glycemic control in patients with type 2 diabetes.

  1. R Moses,
  2. R Slobodniuk,
  3. S Boyages,
  4. S Colagiuri,
  5. W Kidson,
  6. J Carter,
  7. T Donnelly,
  8. P Moffitt and
  9. H Hopkins
  1. Department of Endocrinology, Illawarra Regional Hospital, Wollongong, Australia. robert_moses@uow.edu.au
    Diabetes Care 1999 Jan; 22(1): 119-124. https://doi.org/10.2337/diacare.22.1.119
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    Abstract

    OBJECTIVE: To compare the effect of repaglinide in combination with metformin with monotherapy of each drug on glycemic control in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 83 patients with type 2 diabetes who had inadequate glycemic control (HbA1c > 7.1%) when receiving the antidiabetic agent metformin were enrolled in this multicenter, double-blind trial. Subjects were randomized to continue with their prestudy dose of metformin (n = 27), to continue with their prestudy dose of metformin with the addition of repaglinide (n = 27), or to receive repaglinide alone (n = 29). For patients receiving repaglinide, the optimal dose was determined during a 4- to 8-week titration and continued for a 3-month maintenance period. RESULTS: In subjects receiving combined therapy, HbA1c was reduced by 1.4 +/- 0.2%, from 8.3 to 6.9% (P = 0.0016) and fasting plasma glucose by 2.2 mmol/l (P = 0.0003). No significant changes were observed in subjects treated with either repaglinide or metformin monotherapy in HbA1c (0.4 and 0.3% decrease, respectively) or fasting plasma glucose (0.5 mmol/l increase and 0.3 mmol/l decrease respectively). Subjects receiving repaglinide either alone or in combination with metformin, had an increase in fasting levels of insulin between baseline and the end of the trial of 4.04 +/- 1.56 and 4.23 +/- 1.50 mU/l, respectively (P < 0.02). Gastrointestinal adverse events were common in the metformin group. An increase in body weight occurred in the repaglinide and combined therapy groups (2.4 +/- 0.5 and 3.0 +/- 0.5 kg, respectively; P < 0.05). CONCLUSIONS: Combined metformin and repaglinide therapy resulted in superior glycemic control compared with repaglinide or metformin monotherapy in patients with type 2 diabetes whose glycemia had not been well controlled on metformin alone. Repaglinide monotherapy was as effective as metformin monotherapy.

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    January 1999, 22(1)
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    Effect of repaglinide addition to metformin monotherapy on glycemic control in patients with type 2 diabetes.
    R Moses, R Slobodniuk, S Boyages, S Colagiuri, W Kidson, J Carter, T Donnelly, P Moffitt, H Hopkins
    Diabetes Care Jan 1999, 22 (1) 119-124; DOI: 10.2337/diacare.22.1.119

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    Effect of repaglinide addition to metformin monotherapy on glycemic control in patients with type 2 diabetes.
    R Moses, R Slobodniuk, S Boyages, S Colagiuri, W Kidson, J Carter, T Donnelly, P Moffitt, H Hopkins
    Diabetes Care Jan 1999, 22 (1) 119-124; DOI: 10.2337/diacare.22.1.119
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