Zafar Ullah Khan, Muhammad Adnan Iqbal, Muhammad Arif Nadeem, Sara Shoaib.
Rosiglitazone and Metformin in patients with type-2 Diabetes Mellitus who are inadequately controlled on Metformin alone.
Ann King Edward Med Uni Jan ;11(1):20-3.

Type 2 Diabetes Mellitus is almost reaching epidemic levels. With tight hyperglycemic control the risk reduction is 24% for any diabetes related end-point and 32% for death related to diabetes, against only 0.9% decrease in HbAlc level. Complementary mode of actions of Rosiglitazone and Metformin can be used to maximize the therapeutic effect and to decrease the side effects. We evaluated the efficacy, safety and tolerability of the combination of Rosiglitazone and Metformin on change in HbAlc levels from baseline over a period 24 weeks in patients with type 2 diabetes mellitus. Twenty eight type 2 diabetes mellitus patients were recruited randomly presenting to West Medical Ward, Mayo hospital Lahore, through OPD, Diabetic Clinic and Emergency, who were on Metformin alone and were poorly controlled from September 2003 to July 2004. They were given Rosiglitazone 4 mg/day or 8 mg/day with metformin for a period of 24 weeks. Only 2 patients were dropped and 26 patients completed the study (46% were males and 54% were females), and none of patient was dropped due to adverse effects. Their fasting blood sugar measured at baseline and at 4, 8, 16 and 24 week. HbAlc was measured at start and at 24 weeks. The fasting blood glucose responders were 84.6%, with mean fall of 46 mg/dl. HbAlc responders were 73% patients. Average weight gain was 1.125 kg over 24 weeks. Out of 26 patients, 89% showed a mild decrease in hemoglobin concentration but none reaching anemic levels. Only 10% patients had a rise in liver enzymes, which was less than 2 times the normal. Addition of rosiglitazone, in patients with type 2 diabetes mellitus, who are inadequately controlled on metformin alone, resulted in better glycemic control but a large scale study is required and other combinations with Rosiglitazone like sulphonylurea and insulin should be compared.

USER COMMENTS

After reading the title of the article, it is difficult to know whether article is about finding Rosiglitazone and Metformin in patients (may be in their pockets?) or treating patients with these drugs. Authors should have spent more time in selecting the title of their article. In a disease such as Diabetes Mellitus type 2, where there is progressive worsening of the disease, not having a control group severely limits the utility of the study. As I have access to abstract only, I will limit my comments to these two points. I assume other deficiences in the abstract are addressed in the manuscript of the article.
Posted by: rqayyum on Aug 2005

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