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Low-dose combination therapy with rosiglitazone and metformin to prevent type 2 diabetes mellitus (CANOE trial): a

Bernard Zinman1, Stewart B Harris, Jan Neuman

  • 1Department of Medicine, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada. zinman@lunenfeld.ca

Lancet (London, England)
|July 8, 2010
PubMed
Abstract

Insights

Low-dose rosiglitazone and metformin significantly reduced type 2 diabetes development in patients with impaired glucose tolerance. This combination therapy proved effective for diabetes prevention with manageable side effects.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Clinical Trials

Background:

  • Type 2 diabetes epidemic necessitates effective prevention strategies.
  • The CANOE trial evaluated low-dose combination therapy for diabetes prevention.

Purpose of the Study:

  • To investigate the efficacy of low-dose rosiglitazone and metformin combination therapy in preventing type 2 diabetes.
  • To assess the safety and effectiveness of this therapeutic approach in patients with impaired glucose tolerance.

Main Methods:

  • Double-blind, randomized controlled trial with 207 patients with impaired glucose tolerance.
  • Participants received either rosiglitazone (2 mg) and metformin (500 mg) twice daily or placebo for a median of 3.9 years.
  • Primary outcome: time to diabetes development via oral glucose tolerance test or fasting plasma glucose.

Main Results:

  • Significantly fewer participants in the active treatment group developed diabetes (14%) compared to placebo (39%).
  • Relative risk reduction of 66% and absolute risk reduction of 26% for diabetes incidence.
  • 80% of the treatment group regressed to normal glucose tolerance versus 53% in the placebo group. Increased diarrhea observed in the treatment group.

Conclusions:

  • Low-dose rosiglitazone and metformin combination therapy is highly effective in preventing type 2 diabetes in individuals with impaired glucose tolerance.
  • The combination therapy demonstrated a favorable safety profile regarding major adverse events.
  • This approach offers a viable strategy for diabetes prevention.

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