Vnitr Lek. 2004 Nov;50(11):818-24.
[Rosiglitazon in treatment of Type
II diabetes mellitus--experience of diabetologists in the Czech
Republic. Part I: compensation of diabetes, sugar metabolism] [Article
in Czech]
Perusicova J, Haas T.
Diabetologicke centrum, III. interni klinika 1. lekarske fakulty
UK a VFN, Praha.
Thiazolidindione derivates (glitazones) make a very promising group
of peroral antidiabetic drugs. They are represented by rosiglitazon
which is available on our market to type II diabetics. As far as
sugar metabolism is concerned, rosiglitazon can reduce glycaemia
and insulin level both when fasting and postprandially. GOAL: The
goal of the authors' work was to gain their own experience with
rosiglitazon treatment in type II diabetics in the Czech Republic.
Sample: The monitored sample consisted of 388 patients with insufficiently
compensated type II diabetes when treated by sulphonylurea compounds
or metformine. METHODS: 95 diabetologists from diabetology medical
offices started a 6-month-long treatment with rosiglitazon (Avandia)
dose of 4 mg a day as stated in European recommendations. In order
to assess changes in sugar metabolism (compensation of diabetes)
glycaemia and C peptide were monitored when fasting and postpradially
and HbA1c was monitored in 2-month-long intervals. RESULTS: Weight,
waist-hip ratio (WHR) and C-peptide levels remained unchanged. Statistically
significant (p < 0.0001) was a HbA1c decrease over 6 month from
9.61% to 8.48%. Fasting glycaemia decreased by 2.49 and postprandial
glycaemia by 2.71 mmol/l. No significant side effects were identified.
CONCLUSION: Rosiglitazon administration combined with administration
of sulphonylurea compounds or metformine significantly improved
compensation of diabetes compared to initial therapy.
J Clin Endocrinol Metab. 2004 Dec;89(12):6048-53.
Rosiglitazone, but not glyburide,
reduces circulating proinsulin and the proinsulin:insulin ratio
in type 2 diabetes.
Smith SA, Porter LE, Biswas N, Freed MI.
Scientific Affairs, Diabetes, GlaxoSmithKline, Harlow, Essex,
CM19 5AW, United Kingdom.
An elevation in the ratio of proinsulin (PI) to immunoreactive
insulin (IRI) is inversely related to beta-cell function in type
2 diabetes, and increased PI is an independent risk factor for
coronary heart disease. An objective of the present studies was
to assess the effects of the thiazolidinedione insulin sensitizer,
rosiglitazone, on indirect markers of beta-cell function and cardiovascular
risk in people with type 2 diabetes by measuring plasma PI and
the PI:IRI ratio. Parameters of insulin processing, including
plasma PI and PI:IRI ratios, were determined in type 2 diabetes
patients enrolled in two randomized double-blind studies comparing
the effects of rosiglitazone (4 or 8 mg/d) with placebo (study
1, 26-wk treatment) or the sulfonylurea glyburide (study 2, 52-wk
treatment). Treatment with rosiglitazone for 26 wk (study 1) produced
significant dose-dependent decreases in both plasma PI concentrations
(18-29%) and the PI:IRI ratio compared with baseline (7-14%) and
placebo (19-29%) (P < 0.001). A significant increase in the
PI:IRI ratio in placebo-treated patients occurred (P < 0.001).
In study 2, rosiglitazone also significantly reduced both plasma
PI and the PI:IRI ratio compared with baseline (P < 0.001).
In contrast, glyburide significantly increased both plasma PI
(45%; P < 0.001) and the PI:IRI ratio (10%) (P < 0.05 vs.
baseline). These results show that rosiglitazone and glyburide
have differential effects on absolute PI levels and the PI:IRI
ratio in people with type 2 diabetes.
