Troglitazone in combination with sulphonylurea improves glycaemic control in Type 2 diabetic patients inadequately controlled by sulphonylurea therapy alone
M. Buysschaert et al., Troglitazone in combination with sulphonylurea improves glycaemic control in Type 2 diabetic patients inadequately controlled by sulphonylurea therapy alone, DIABET MED, 16(2), 1999, pp. 147-153
Aim The aim of this study was to investigate the effectiveness of troglitaz
one (a peroxisome proliferator-activated receptor-gamma agonist developed p
rimarily for the treatment of Type 2 diabetes mellitus (DM)), 100 or 200 mg
/day, in terms of glycaemic control, lipid profile and tolerability, when g
iven in addition to existing sulphonylurea therapy.
Methods A 16-week, randomized, parallel-group placebo-controlled trial in 2
59 Type 2 diabetic patients already on sulphonylurea therapy.
Results At week 16, adjusted geometric mean HbA1c with troglitazone 100 mg
(7.7%; P = 0.023) and 200 mg (7.4%; P < 0.001) was lower with sulphonylurea
alone (8.2%). At all weeks, adjusted geometric mean fasting serum glucose
levels were lower in both troglitazone groups, compared with sulphonylurea
alone (P = 0.007 to P < 0.001). At week 16, both troglitazone groups showed
reductions in immune reactive insulin compared with sulphonylurea alone (2
00 mg, 13%; P = 0.032: 100 mg, 5%; NS), Troglitazone reduced serum levels o
f nonesterified fatty acids at week 16 (100 mg, 12%; P = 0.042) and at all
weeks (200 mg, 17 - 24%; P = 0.014 to P < 0.001). The incidence of drug-rel
ated adverse events was similar in all groups (23-24% of patients). There w
as no apparent association between hypoglycaemia and the addition of trogli
tazone to sulphonylurea therapy.
Conclusions Troglitazone 100 or 200 mg added to usual sulphonylurea therapy
in patients with Type 2 DM is associated with a significant improvement in
glycaemic control, without altering the adverse-event profile of the sulph
onylurea.