A randomized controlled trial examining combinations of repaglinide, metformin and NPH insulin
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A randomized controlled trial examining combinations of repaglinide, metformin and NPH insulin. / Davies, M. J.; Thaware, P. K.; Tringham, J. R.; Howe, J.; Jarvis, J.; Johnston, V.; Kitchener, D. L.; Skinner, T. C.; McNally, P. G.; Lawrence, I. G.
In: Diabetic Medicine, Vol. 24, No. 7, 2007, p. 714-719.Research output: Contribution to journal › Journal article › peer-review
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T1 - A randomized controlled trial examining combinations of repaglinide, metformin and NPH insulin
AU - Davies, M. J.
AU - Thaware, P. K.
AU - Tringham, J. R.
AU - Howe, J.
AU - Jarvis, J.
AU - Johnston, V.
AU - Kitchener, D. L.
AU - Skinner, T. C.
AU - McNally, P. G.
AU - Lawrence, I. G.
PY - 2007
Y1 - 2007
N2 - Aims: To compare combination use of repaglinide, metformin and bedtime Neutral Protamine Hagedorn (NPH) insulin with conventional approaches of insulin initiation in patients with Type 2 diabetes (T2DM). Methods: Eighty-two patients with T2DM with suboptimal glycaemic control on oral glucose-lowering agents were randomized to one of three treatment regimens for 4 months. Group 1 received metformin and twice daily biphasic 30/70 human insulin mixture (n = 27), group 2 metformin and bedtime NPH insulin (n = 26) and group 3 metformin, bedtime NPH insulin and mealtime repaglinide (n = 25). Results: Seventy-five patients completed the study. Baseline and end-point mean HbA1c levels fell from 9.0 ± 1.1 to 7.9 ± 1.1% in group 1, 10.0 ± 2.2 to 9.2 ± 1.4% group 2 and 10.0 ± 1.7 to 8.1 ± 1.5% in group 3, respectively. All groups showed improvements in HbA1c. There was no significant difference between groups in the proportions of patients experiencing hypoglycaemia (29.6, 25.0 and 16.7%, respectively; P = 0.55) or in mean weight gain (2.9, 0.7 and 2.2 kg, respectively; P = 0.06). By 4 months, insulin doses were 0.63 ± 0.32 IU/kg in group 1, 0.58 ± 0.21 IU/kg in group 2 and 0.37 ± 0.22 IU/kg in group 3 (group 3 vs. groups 1 and 2: P < 0.002). Conclusions: The approach using repaglinide, metformin and NPH insulin improved glycaemic control with a similar safety profile to conventional insulin initiation in T2DM and produced final glycaemic control similar to metformin and a twice daily biphasic insulin mixture.
AB - Aims: To compare combination use of repaglinide, metformin and bedtime Neutral Protamine Hagedorn (NPH) insulin with conventional approaches of insulin initiation in patients with Type 2 diabetes (T2DM). Methods: Eighty-two patients with T2DM with suboptimal glycaemic control on oral glucose-lowering agents were randomized to one of three treatment regimens for 4 months. Group 1 received metformin and twice daily biphasic 30/70 human insulin mixture (n = 27), group 2 metformin and bedtime NPH insulin (n = 26) and group 3 metformin, bedtime NPH insulin and mealtime repaglinide (n = 25). Results: Seventy-five patients completed the study. Baseline and end-point mean HbA1c levels fell from 9.0 ± 1.1 to 7.9 ± 1.1% in group 1, 10.0 ± 2.2 to 9.2 ± 1.4% group 2 and 10.0 ± 1.7 to 8.1 ± 1.5% in group 3, respectively. All groups showed improvements in HbA1c. There was no significant difference between groups in the proportions of patients experiencing hypoglycaemia (29.6, 25.0 and 16.7%, respectively; P = 0.55) or in mean weight gain (2.9, 0.7 and 2.2 kg, respectively; P = 0.06). By 4 months, insulin doses were 0.63 ± 0.32 IU/kg in group 1, 0.58 ± 0.21 IU/kg in group 2 and 0.37 ± 0.22 IU/kg in group 3 (group 3 vs. groups 1 and 2: P < 0.002). Conclusions: The approach using repaglinide, metformin and NPH insulin improved glycaemic control with a similar safety profile to conventional insulin initiation in T2DM and produced final glycaemic control similar to metformin and a twice daily biphasic insulin mixture.
KW - Combination therapy
KW - Insulin
KW - Metformin
KW - Repaglinide
KW - Type 2 diabetes
U2 - 10.1111/j.1464-5491.2007.02128.x
DO - 10.1111/j.1464-5491.2007.02128.x
M3 - Journal article
C2 - 17403126
AN - SCOPUS:34347374718
VL - 24
SP - 714
EP - 719
JO - Diabetic Medicine Online
JF - Diabetic Medicine Online
SN - 1464-5491
IS - 7
ER -
ID: 189876318