| Topic: | Diabetes (DM) |
| Title: | Comparison of Insulin Monotherapy and Combination Therapy with Insulin and Metformin or Insulin and Troglitazone in Type 2 Diabetes. |
| Author: | Strowig, S.M.; Aviles-Santa, M.L.; Raskin, P. |
| Source: | Diabetes Care. 25(10): 1691-1698. October 2002. |
| Availability: | Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. |
| Abstract: | This article reports on a study undertaken to evaluate the safety and effectiveness of treatment with insulin alone, insulin plus metformin, or insulin plus troglitazone in individuals with type 2 diabetes. A total of 88 patients with type 2 diabetes using insulin monotherapy were randomly assigned to insulin alone (n = 31), insulin plus metformin (n = 27) or insulin plus troglitazone (n = 30) for 4 months. The insulin dose was increased only in the insulin alone group. Metformin was titrated to a maximum dose of 2,000 milligrams and troglitazone to 600 milligrams. HbA1c (glycosylated hemoglobin, a measure of blood glucose over time) levels decreased in all groups; the lower level occurred in the insulin plus troglitazone group. Body weight increased by 0.5 kilograms in the insulin plus metformin group, whereas the other two groups gained 4.4 kilograms. Triglyceride and VLDL triglyceride levels significantly improved only in the insulin plus troglitazone group. Subjects taking metformin experienced significantly more gastrointestinal side effects and less hypoglycemia. The authors conclude that aggressive insulin therapy significantly improved glycemic control in type 2 diabetes subjects to levels comparable with those achieved by adding metformin to the insulin therapy. Troglitazone was the most effective in lowering HbA1c, total daily insulin dose, and triglyceride levels. However, treatment with insulin plus metformin was advantageous in avoiding weight gain and hypoglycemia. 1 figure. 2 tables. 49 references. |
| Format: | Journal Article |
| Language: | English. |
| Major Keywords: | Diabetes Mellitus. Insulin. Type 2 Diabetes. Metformin. Troglitazone. Drug Therapy. Drug Effects. |
| Minor Keywords: | Weight Loss. Body Weight. Glycosylated Hemoglobin. Hyperlipidemia. Administration and Dosage. Hypoglycemia. |
| Publication Number: | DMJA10650 |
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