Effects of Rosiglitazone, Glyburide, and Metformin on β-Cell Function and Insulin Sensitivity in ADOPT
- Steven E. Kahn1⇓,
- John M. Lachin2,
- Bernard Zinman3,
- Steven M. Haffner4,
- R. Paul Aftring5,
- Gitanjali Paul5,
- Barbara G. Kravitz5,
- William H. Herman6,
- Giancarlo Viberti7,
- Rury R. Holman8 and
- and the ADOPT Study Group*
- 1Department of Medicine, Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, Washington
- 2Biostatistics Center, George Washington University, Rockville, Maryland
- 3Samuel Lunenfeld Research Institute, Mount Sinai Hospital and University of Toronto, Ontario, Canada
- 4San Antonio Texas
- 5GlaxoSmithKline, King of Prussia, Pennsylvania
- 6Departments of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, Michigan
- 7King’s College London School of Medicine, King’s College London, London, U.K.
- 8Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University, Oxford, U.K.
- Corresponding author: Steven E. Kahn, .
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 β-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-naïve 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 β-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 β-cell function in those who failed to maintain adequate glucose control with initial monotherapy.
CONCLUSIONS The favorable combined changes in β-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.
- Received October 18, 2010.
- Accepted February 8, 2011.
- © 2011 by the American Diabetes Association.
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