Effects of rosiglitazone, glyburide, and metformin on β-cell function and insulin sensitivity in ADOPT.

Journal article

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.

Authors: Kahn, SE; Lachin, J; Zinman, B; Haffner, S; Aftring, R

• Publication status: Published
• Journal: Diabetes
• Volume: 60
• Issue: 5
• Pages: 1552-1560
• Publication date: 2011-05-01
• DOI: 10.2337/db10-1392
• EISSN: 1939-327X
• ISSN: 0012-1797
• Language: English
• Keywords: Middle Aged; Male; Humans; Female; Glyburide; Aged; Diabetes Mellitus, Type 2; ADOPT Study Group; Hypoglycemic Agents; Thiazolidinediones; Insulin Resistance; Metformin; Insulin-Secreting Cells