| Abstract: |
This article reports on a study undertaken to compare the effect on glycemic control and weight gain of repaglinide versus metformin combined with bedtime NPH insulin in patients with type 2 diabetes. A total of 80 subjects treated with 850 or 1,000 milligrams metformin (3 times daily) combined with bedtime NPH insulin were randomized to 13 weeks of open label treatment with 4 milligrams repaglinide (3 times daily, n = 39) or metformin (dose unchanged, n = 41). Insulin dose was titrated at the clinician's discretion, aiming for a fasting blood glucose less than 6.0 mmol per liter. Baseline age, diabetes duration, insulin requirement, weight, and glycosylated hemoglobin (HbA1c, a measure of blood glucose over time) were similar. Glycemic control improved (nonsignificantly) with insulin and metformin but deteriorated with insulin and repaglinide. Weight gain was less with insulin and metformin. Diabetes Treatment Satisfaction Questionnaire Score increased with insulin and metformin, but decreased with insulin and repaglinide. The authors conclude that, combined with bedtime NPH insulin, metformin provides superior glycemic control to repaglinide with less weight gain and improved diabetes treatment satisfaction. 3 figures. 1 table. 20 references. |