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| Slide Lecture Programs |
| 2006 Core Curriculum |
| Targeting Insulin Resistance for Vascular Protection |
July 31, 2006
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| III: |
Clinical Imperatives When Treating Patients with Diabetes
- This study compared the effect of rosiglitazone vs glyburide on glycemic control in 203 patients with type 2 diabetes. Patients ranged in age from 40 to 77 years; mean diabetes duration at baseline was 6.2 years in the glyburide group and 5.3 years in the rosiglitazone group.
- After a 2-week screening period and a 4-week run-in period, patients were randomized to rosiglitazone 8 mg daily (n = 104) or glyburide (titrated to achieve optimal glycemic control for the first 8 weeks and then held constant, mean dose 10.5 mg/day; n = 99). The treatment period was 52 weeks.
- Both treatments achieved significant reductions in A1C and FPG at week 52. However, the pattern of glycemic decreases differed: Glyburide treatment resulted in an initially rapid reduction in A1C from week 0 through 16, after which glycemic control progressively deteriorated. In contrast, the progressive reductions in A1C were sustained with rosiglitazone.
- At week 52, 28% of patients in the rosiglitazone group achieved an A1C of <7% vs 13% in the glyburide group.
- In rosiglitazone-treated patients, mean FPG decreased rapidly between weeks 0 and 8, and continued to decrease to week 52. In the glyburide-treated patients, FPG decreased more dramatically between weeks 0 and 8, remained stable to week 16, and gradually increased through week 52.
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