Effects of Rosiglitazone, Glyburide, and Meiformin on beta-Cell Function and Insulin Sensitivity in ADOPT

TY - JOUR

T1 - Effects of Rosiglitazone, Glyburide, and Meiformin on beta-Cell Function and Insulin Sensitivity in ADOPT

AU - Kahn, Steven E.

AU - Lachin, John M.

AU - Zinman, Bernard

AU - Haffner, Steven M.

AU - Aftring, R. Paul

AU - Pau, Gitanjali

AU - Kravitz, Barbara G.

AU - Herman, William H.

AU - Viberti, Giancarlo

AU - Holman, Rury R.

PY - 2011/5

Y1 - 2011/5

N2 - OBJECTIVE-ADOPT (A Diabetes Outcome Progression Trial) demonstrated that initial monotherapy with rosiglitazone provided superior durability of glycemic control compared with metformin and glyburide in patients with recently diagnosed type 2 diabetes. Herein, we examine measures of beta-cell function and insulin sensitivity from an oral glucose tolerance test (OGTT) over a 4-year period among the three treatments. RESEARCH DESIGN AND METHODS-Recently diagnosed, drug-naive patients with type 2 diabetes (4,360 total) were treated for a median of 4.0 years with rosiglitazone, metformin, or glyburide and were examined with periodic metabolic testing using an OGTT. RESULTS-Measures of beta-cell function and insulin sensitivity from an OGTT showed more favorable changes over time with rosiglitazone versus metformin or glyburide. Persistent improvements were seen in those who completed 4 years of monotherapy and marked deterioration of beta-cell function in those who failed to maintain adequate glucose control with initial monotherapy. CONCLUSIONS-The favorable combined changes in beta-cell function and insulin sensitivity over time with rosiglitazone appear to be responsible for its superior glycemic durability over metformin and glyburide as initial monotherapy in type 2 diabetes. Diabetes 60:1552-1560, 2011

AB - OBJECTIVE-ADOPT (A Diabetes Outcome Progression Trial) demonstrated that initial monotherapy with rosiglitazone provided superior durability of glycemic control compared with metformin and glyburide in patients with recently diagnosed type 2 diabetes. Herein, we examine measures of beta-cell function and insulin sensitivity from an oral glucose tolerance test (OGTT) over a 4-year period among the three treatments. RESEARCH DESIGN AND METHODS-Recently diagnosed, drug-naive patients with type 2 diabetes (4,360 total) were treated for a median of 4.0 years with rosiglitazone, metformin, or glyburide and were examined with periodic metabolic testing using an OGTT. RESULTS-Measures of beta-cell function and insulin sensitivity from an OGTT showed more favorable changes over time with rosiglitazone versus metformin or glyburide. Persistent improvements were seen in those who completed 4 years of monotherapy and marked deterioration of beta-cell function in those who failed to maintain adequate glucose control with initial monotherapy. CONCLUSIONS-The favorable combined changes in beta-cell function and insulin sensitivity over time with rosiglitazone appear to be responsible for its superior glycemic durability over metformin and glyburide as initial monotherapy in type 2 diabetes. Diabetes 60:1552-1560, 2011

U2 - 10.2337/db10-1392

DO - 10.2337/db10-1392

M3 - Article

VL - 60

SP - 1552

EP - 1560

JO - Diabetes

JF - Diabetes

IS - 5

ER -