Impact of rosiglitazone on glycaemic control, insulin levels and blood pressure values in patients with type 2 diabetes.

INTRODUCTION The main metabolic defect responsible for hyperglycaemia in type 2 diabetes is insulin resistance and impaired B-cell function. Currently much more medications which combat impaired B-cell function are available then those which might inhance insulin sensitivity. A novel oral hypoglycaemic agent, rosiglitazone, targeting insulin resistance, not yet registered in our country, has been available in majority of Europian countries. The main aim of the study was to evaluate the efficacy of rosiglitazone in the treatment of patients with type 2 diabetes patients compared with glibenclamide monotherapy. METHODS A total sample of 20 diabetic patients, who had not achieved satisfactory control with dietary modifications, was selected. 10 patients were randomised to rosiglitazone treatment in daily dosage of 4 to 8 mg (RG group) while the rest of the patients were receiving glibenclamide in the dosage of 3.5-10.5 mg daily (GC group). All the patients had their fasting and postprandial glycaemia, HbAlc, fasting insulin and blood pressure measured at baseline and 3 months after initiation of the treatment. Possible increase of the liver enzymes in the RG group was followed up. RESULTS There was a significant reduction in glycaemic parameters in both groups in comparison to baseline values. However fasting insulin levels in the RG group were significantly reduced while slight but not significant increase was noted in GC group. Blood pressure values were significantly reduced in the RG group while no changes were noted in the GC group. CONCLUSION Results indicate significant improvement of glucose utilisation as a consequence of reduced insulin resistance in the RG group. Treatment with rosiglitazone lead to improved insulin sensitivity which may predict longer term preservation of B-cell function. In addition, this novel agent also have favourable impact to blood pressure values which is of exceptional importance in the complex management of type 2 diabetic patient.