PAS: Combined Treatment Ups Glycemic Control in Young

Rosiglitazone plus metformin beats metformin alone or lifestyle interventions in adolescents with T2DM

MONDAY, April 30 (HealthDay News) -- The addition of rosiglitazone, but not lifestyle interventions, to metformin treatment improves glycemic control in young people with type 2 diabetes, according to a study published online April 29 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the Pediatric Academic Societies, held from April 28 to May 1 in Boston.

Phil Zeitler, M.D., Ph.D., from the University of Colorado in Denver, and colleagues compared three treatment regimens among 699 children and adolescents (10 to 17 years old) with a recent diagnosis of type 2 diabetes (mean duration, 7.8 months). Participants were treated with metformin to reduce glycated hemoglobin to less than 8 percent, then randomized to receive metformin alone, metformin plus rosiglitazone, or metformin plus a lifestyle intervention program focused on weight loss.

After an average follow-up of 3.86 years, the researchers found that 45.6 percent of patients experienced loss of glycemic control. The rates of treatment failure were 51.7 percent for metformin alone, 38.6 percent for metformin plus rosiglitazone, and 46.6 percent for metformin plus lifestyle intervention. Only metformin plus rosiglitazone was statistically superior to metformin alone; metformin plus lifestyle intervention was not significantly different from metformin plus rosiglitazone or metformin alone. Differences in sustained effectiveness were noted according to race or ethnic group and gender. There were serious adverse events in 19.2 percent of patients.

"Metformin alone was effective in maintaining durable glycemic control in only half the study participants, and the addition of rosiglitazone, but not intensive lifestyle intervention, was superior to metformin alone," Zeitler and colleagues conclude.

The study was funded in part by the pharmaceutical industry; several authors disclosed financial ties to pharmaceutical and/or weight-loss management companies.

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