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Troglitazone use in insulin-treated type 2 diabetic patients. The Troglitazone Insulin Study Group
J B Buse1, B Gumbiner, N P Mathias
1Department of Medicine, Diabetes Care Center, University of North Carolina, Chapel Hill, USA.
Diabetes Care
|September 4, 1998
Summary
Troglitazone significantly reduced insulin dose needs and improved blood glucose control in patients with type 2 diabetes. This study demonstrates troglitazone
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Type 2 diabetes mellitus (T2DM) is a progressive metabolic disorder.
- Insulin therapy is often required for glycemic control in advanced T2DM.
- Optimizing insulin requirements while maintaining glycemic control is a clinical challenge.
Purpose of the Study:
- To evaluate the efficacy of troglitazone in reducing insulin dosage in patients with T2DM.
- To assess the impact of troglitazone on glycemic control (fasting blood glucose and HbA1c) in insulin-treated T2DM patients.
Main Methods:
- A 26-week double-blind, placebo-controlled study with an open-label extension.
- Included insulin-treated T2DM patients who previously failed oral antidiabetic agents.
- Patients received 200 or 400 mg troglitazone or placebo, with insulin dose adjustments based on glycemic targets.
Main Results:
- Troglitazone groups showed significantly higher rates of achieving >50% insulin reduction compared to placebo (22-27% vs. 7%, P < 0.01).
- Mean insulin dose reductions were greater with troglitazone (30-41 U) versus placebo (13 U).
- Troglitazone led to significant reductions in HbA1c (up to 0.41% with 400 mg) and fasting serum glucose in the open-label extension.
Conclusions:
- Troglitazone effectively decreases daily injected insulin requirements in insulin-treated T2DM patients.
- Troglitazone improves glycemic control, as evidenced by reductions in HbA1c and fasting glucose.
- Troglitazone represents a viable therapeutic option for managing insulin-dependent type 2 diabetes.