Addition of rosiglitazone to metformin is most effective in obese, insulin-resistant patients with type 2 diabetes

  1. T. A. Jones1,*,
  2. M. Sautter2,
  3. L. F. Van Gaal3,
  4. N. P. Jones1

Article first published online: 4 APR 2003

DOI: 10.1046/j.1463-1326.2003.00258.x

Issue

Diabetes, Obesity and Metabolism

Diabetes, Obesity and Metabolism

Volume 5, Issue 3, pages 163–170, May 2003

Additional Information

How to Cite

Jones, T. A., Sautter, M., Van Gaal, L. F. and Jones, N. P. (2003), Addition of rosiglitazone to metformin is most effective in obese, insulin-resistant patients with type 2 diabetes. Diabetes, Obesity and Metabolism, 5: 163–170. doi: 10.1046/j.1463-1326.2003.00258.x

Author Information

  1. 1

    GlaxoSmithKline, Harlow, UK

  2. 2

    GlaxoSmithKline, Collegeville, PA, USA

  3. 3

    Department of Endocrinology and Metabolism, University Hospital, Antwerp, Belgium

*Correspondence: Mr N. P. Jones, GlaxoSmithKline, New Frontiers Science Park (South), Third Avenue, Harlow, Essex, CM19 5AW, UK. E-mail: Nigel_P_Jones@gsk.com

Publication History

  1. Issue published online: 4 APR 2003
  2. Article first published online: 4 APR 2003
  3. Received 26 June 2001; returned for revision 12 July 2001; revised version accepted 28 November 2002

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Keywords:

  • type 2 diabetes;
  • obesity;
  • rosiglitazone;
  • metformin;
  • glycaemic control;
  • insulin resistance;
  • beta-cell function

Aim:  These analyses were undertaken to evaluate the efficacy of the insulin sensitizer rosiglitazone (RSG) when added to the therapy of obese type 2 diabetes mellitus patients (T2DM) taking near-maximal doses (2.5 g/day) of metformin (MET). In obese, insulin-resistant patients with T2DM who are inadequately controlled on MET, the addition of an agent that reduces insulin resistance may be a more rational and innovative approach than the addition of an insulin secretagogue.

Methods:  Data were pooled from two double-blind studies of RSG added to 2.5 g/day MET, involving a total of 550 T2DM patients. Patients were categorized as non-overweight, overweight and obese according to their baseline BMI using WHO criteria (<25 kgm−2, 25–30 kgm−2, >30 kgm−2 respectively).

Results:  RSG improved glycaemia (HbA1c) and fasting plasma glucose (FPG) to a clinically significant extent in all three subgroups but the effect was most pronounced in the obese patients. Improvements in HOMA estimates of insulin resistance and beta-cell function were also greatest in the obese patients (4 mg: −16% and +19%; 8 mg: −37% and + 33% respectively), as were reductions in fasting insulin. The profile of adverse events was not demonstrably different in obese patients from the non-obese.

Conclusions:  In obese type 2 diabetic patients inadequately controlled on MET alone, addition of rosiglitazone improves glycaemic control, insulin sensitivity and beta-cell function to a clinically important extent.

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