Therapeutic efficacy and factors that affect response of rosiglitazone in insulin-resistant type 2 diabetes
Year: 2003
Type: article
Study design: Clinical Trial
Abstract: Background: Rosiglitazone, an insulin sensitizer of thiazolidinedione class, is known as a highly selective and potent agonist for the peroxisome proliferator-activated receptor-款. This study was performed to evaluate the antidiabetic \nactivity \nand insulin sensitizing effect of rosiglitazone combination therapy in insulin-resistant type 2 diabetic patients who were poorly controlled with oral agents such as metformin and/or sulfonylurea. The factors affecting response of rosiglitazone \nwere \nalso evaluated on the basis of the degree of glycemic control.\n\nMethods: One hundred twenty insulin-resistant (glucose disposal rate, Kitt < 2.5%/min) type 2 diabetic patients (M:F=42:78, mean age 58.6짹9.2 years, body mass index 24.2짹2.8 �럮/�렊) were enrolled and randomly divided into two groups. For \n12 \nweeks, the treated group daily received 4 �럫 of rosiglitazone and the control group had diet and exercise therapy in addition to previous medications. The responders were defined as more than 20% decrease of fasting plasma glucose level or more \nthan 1% \ndecrease of HbA1c. As for the indices of insulin resistance and insulin secretory function, Kitt (Kitt=0.693/t1/2 횞 100) by insulin tolerance test, HOMAIR and HOMA棺-cell function by �쁇OMA index (Homeostasis \nmodel \nassessment)�� were evaluated.\n\nResults: In rosiglitazone treated group (60 patients, M:F=19:45), 12 weeks of rosiglitazone treatment decreased fasting plasma glucose (28.2%), postprandial 2-hour glucose (23.2%), and HbA1c (12.2%). Rosiglitazone also significantly \ndecreased \nHOMAIR (41.2%), and increased Kitt (53.3%) and HOMA棺-cell function (46.9%). Forty-five patients (75%) satisfied responder. Females and those who had higher body mass index and waist-hip ratio showed better response. The \nbasal \nfasting plasma glucose, HbA1c, and systolic blood pressure were also higher in responders. The responders showed significantly higher fasting serum insulin level and HOMAIR, and also higher tendency of fasting serum C-peptide level and \nHOMA棺-cell function than nonresponders.\n\nConclusion: From these results, rosiglitazone treatment can improve not only hyperglycemia and insulin resistance but also insulin secretory function in uncontrolled insulin-resistant type 2 diabetes. The factors that affect response of \nrosiglitazone are female, obesity (especially central obesity), high insulin secretory function, and severe insulin resistance. As a conclusion, the therapeutic efficacy or response of rosiglitazone is likely to depend on the degree of preserved \npancreatic 棺-cell function and the severity of insulin resistance.
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2465249940