Effects of Rosiglitazone, Glyburide, and Metformin on β-Cell Function and Insulin Sensitivity in ADOPT

• Published in: Diabetes (New York, N.Y.) Vol. 60; no. 5; pp. 1552 - 1560
• Main Authors: KAHN, Steven E, LACHIN, John M, ZINMAN, Bernard, HAFFNER, Steven M, PAUL AFTRING, R, PAUL, Gitanjali, KRAVITZ, Barbara G, HERMAN, William H, VIBERTI, Giancarlo, HOLMAN, Rury R
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.05.2011
• Subjects: Aged; Biological and medical sciences; Comparative analysis; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Diabetes therapy; Diabetes. Impaired glucose tolerance; Diagnosis; Drug therapy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Glucose tolerance tests; Glyburide - therapeutic use; Health aspects; Humans; Hypoglycemic agents; Hypoglycemic Agents - therapeutic use; Insulin Resistance - physiology; Insulin-Secreting Cells - drug effects; Male; Medical sciences; Metformin - therapeutic use; Middle Aged; Pathophysiology; Thiazolidinediones - therapeutic use; Type 2 diabetes; United Kingdom; Endocrinopathy; Agonist; Pancreatic hormone; Diabetes mellitus; Langerhans islet; Thiazolidinedione derivatives; PPAR-γ receptor; Insulin; Sensitivity; Biguanides; Sulfonamides; Sulfonylureas; Rosiglitazone; β Cell; Metformin; Glibenclamide; Endocrine pancreas
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db10-1392

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. 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. 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. 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.