Addition of low‐dose rosiglitazone to sulphonylurea therapy improves glycaemic control in Type 2 diabetic patients

Wolffenbuttel, Bruce H. R.; Gomis, Ramón; Squatrito, Sebastiano; Jones, NigelP.; Patwardhan, Rita

doi:10.1046/j.1464-5491.2000.00224.x

Cited by 236 publications

(133 citation statements)

References 30 publications

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“…This response is observed in the absence or presence of sulfonylureas, although, just as we found, thiazolidinedione treatment augments glycemic control over that seen with sulfonylurea monotherapy (46,47). The fact that both troglitazone (46) and rosiglitazone (47) gave a similar result indicates that this is a general effect of thiazolidinediones and not limited to troglitazone.…”

Section: Discussionsupporting

confidence: 66%

Regulation of Glucose Transport and Insulin Signaling by Troglitazone or Metformin in Adipose Tissue of Type 2 Diabetic Subjects

et al. 2002

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Type 2 diabetic subjects failing glyburide therapy were randomized to receive additional therapy with either metformin (2,550 mg/day) or troglitazone (600 mg/day) for 3-4 months. Biopsies of subcutaneous abdominal adipose tissue were obtained before and after therapy. Glycemic control was similar with both treatments. Metformin treatment increased insulin-stimulated whole-body glucose disposal rates by 20% (P < 0.05); the response to troglitazone was greater (44% increase, P < 0.01 vs. baseline, P < 0.05 vs. metformin). Troglitazone-treated subjects displayed a tendency toward weight gain (5 ؎ 2 kg, P < 0.05), increased adipocyte size, and increased serum leptin levels. Metformintreated subjects were weight-stable, with unchanged leptin levels and reduced adipocyte size (to 84 ؎ 4% of control, P < 0.005). Glucose transport in isolated adipocytes from metformin-treated subjects was unaltered from pretreatment. Glucose transport in both the absence (321 ؎ 134% of pre-Rx, P < 0.05) and presence of insulin (418 ؎ 161%, P < 0.05) was elevated after troglitazone treatment. Metformin treatment had no effect on adipocyte content of GLUT1 or GLUT4 proteins. After troglitazone treatment, GLUT4 protein expression was increased twofold (202 ؎ 42%, P < 0.05). Insulin-stimulated serine phosphorylation of Akt was augmented after troglitazone (170 ؎ 34% of pre-Rx response, P < 0.05) treatment and unchanged by metformin. We conclude that the ability of troglitazone to upregulate adipocyte glucose transport, GLUT4 expression, and insulin signaling can contribute to its greater effect on whole-body glucose disposal. Diabetes 51: 30 -36, 2002

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Section: Discussionsupporting

confidence: 66%

Regulation of Glucose Transport and Insulin Signaling by Troglitazone or Metformin in Adipose Tissue of Type 2 Diabetic Subjects

et al. 2002

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“…Rosiglitazone has been shown to be effective in the treatment of type 2 diabetes either as monotherapy or in combination with other agents. In many of the previous studies rosiglitazone had been added on sulphonylurea or metformin monotherapy alone [18,[25][26][27][28], but studies using rosiglitazone in addition to combination therapy are rare [6,20]. In our study, the decreases in HbA 1 c and FPG levels obtained were higher in comparison to the above mentioned triple combination therapy studies [6,20], whereas other parameters were similar.…”

Section: Discussionsupporting

confidence: 58%

“…Rosiglitazone has been shown to prevent the onset of hyperglycaemia [14] and decrease insulin secretion [15] in animal models of insulin resistance and type 2 diabetes mellitus. The efficacy and safety of rosiglitazone as monotherapy have been established in many studies [16][17][18][19].…”

mentioning

confidence: 99%

Addition of Rosiglitazone to Glimepirid and Metformin Combination Therapy in Type 2 Diabetes

Orbay¹,

Sargın²,

Sargın³

et al. 2004

Endocr J

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Abstract. The study was planned to determine the efficacy and safety of adding rosiglitazone to a combination of glimepiride and metformin therapy with insufficiently controlled type 2 diabetes. This was an open-label study with a follow-up period of 26 weeks. Thirty patients were taking 3 mg glimepiride two times and 850 mg metformin two times per day. Patients were told to take one rosiglitazone 4 mg tablet before breakfast additionally. The primary efficacy measure was the mean change in HbA 1 c from baseline to the end of the study. Secondary efficacy parameters included the mean changes from baseline to the end of the study in fasting plasma glucose (FPG) and insulin levels, as well as total cholesterol, HDL-C, LDL-C, triglycerides, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Mean HbA 1 c levels decreased significantly from 7.54 ± 0.9% to 6.57 ± 0.7% (p<0,001) at 26th week. FPG levels fell from 169.39 ± 37.8 mg/dl to 135.69 ± 28.0 mg/dl (p<0.001), respectively. Insulin levels decreased from 19.60 ± 9.8 U/L to 14.66 ± 11.6 U/L (p = 0,026) at 26th week. No one experienced elevations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels greater than 2.5 times the upper limit of the reference range. This study confirms that the addition of rosiglitazone (4 mg/day) to sulphonylurea and metformin treatment for patients with type 2 diabetes improves glycemic control, is safe, and generally well tolerated.

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“…4,5,7 To have 80% power to detect this difference, with a 2-tailed ␣ϭ0.05, we estimated the need for a sample size of 52 subjects. This sample size also provided 90% power, with a 2-tailed ␣ of 0.05, to detect a 25% greater decrease in CRP with rosiglitazone, compared with placebo.…”

Section: Discussionmentioning

confidence: 99%

Effects of Rosiglitazone on Lipids, Adipokines, and Inflammatory Markers in Nondiabetic Patients With Low High-Density Lipoprotein Cholesterol and Metabolic Syndrome

Samaha

Szapary

Iqbal

et al. 2006

ATVB

126

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Background-PPAR-␥ agonists improve insulin sensitivity and glycemic control in type 2 diabetes and may reduce atherosclerosis progression. Thus, PPAR-␥ agonists may be an effective therapy for metabolic syndrome. However, the full spectrum of potentially antiatherogenic mechanisms of PPAR-␥ agonists have not been fully tested in nondiabetic patients with metabolic syndrome. Methods and Results-We performed a prospective, double-blinded, placebo-controlled study of 60 nondiabetic subjects with low high-density lipoprotein cholesterol (HDL-C) level and metabolic syndrome to rosiglitazone 8 mg daily or placebo for 12 weeks. We found no significant effect of rosiglitazone on HDL-C (ϩ5.5% versus ϩ5.8%, Pϭ0.89), and an increase in total cholesterol (ϩ8% versus Ϫ1%; Pϭ0.03). Nevertheless, rosiglitazone significantly increased adiponectin (ϩ168% versus ϩ25%; PϽ0.001), and lowered resistin (Ϫ6% versus ϩ4%; Pϭ0.009), C-reactive protein (Ϫ32% versus ϩ36%, Pϭ0.002), interleukin (IL)-6 (Ϫ22% versus ϩ4%, PϽ0.001), and soluble tumor-necrosis factor-␣ receptor-2 (Ϫ5% versus ϩ7%, PϽ0.001). Conclusions-These findings suggest that rosiglitazone, presumably through its PPAR-␥ agonist properties, has direct effects on inflammatory markers and adipokines in the absence of favorable lipid effects. These findings may help explain the mechanism underlying the possible antiatherosclerotic effects of rosiglitazone.

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Addition of low‐dose rosiglitazone to sulphonylurea therapy improves glycaemic control in Type 2 diabetic patients

Abstract: Overall, the combination of rosiglitazone and a sulphonylurea was safe, well tolerated and effective in patients with Type 2 diabetes.

Cited by 236 publications

References 30 publications

Regulation of Glucose Transport and Insulin Signaling by Troglitazone or Metformin in Adipose Tissue of Type 2 Diabetic Subjects

Regulation of Glucose Transport and Insulin Signaling by Troglitazone or Metformin in Adipose Tissue of Type 2 Diabetic Subjects

Addition of Rosiglitazone to Glimepirid and Metformin Combination Therapy in Type 2 Diabetes

Effects of Rosiglitazone on Lipids, Adipokines, and Inflammatory Markers in Nondiabetic Patients With Low High-Density Lipoprotein Cholesterol and Metabolic Syndrome

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