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Rosiglitazone Aids Insulin in Diabetes Control & Reduced Blood Pressure
  By David Douglas NEW YORK (Reuters Health) - In overweight subjects with type 1 diabetes, adding the thiazolidinedione rosiglitazone to insulin therapy can result in improved glycemic control and a reduction in blood pressure, researchers report in the July issue of Diabetes Care.
Lead researcher Suzanne M. Strowig told Reuters Health that with and without rosiglitazone, "both groups achieved comparable improvements in glycemic control. However, subjects taking rosiglitazone slightly decreased their insulin dose compared with those taking placebo, who required 11% more insulin."
Ms Strowig and Dr. Philip Raskin of the University of Texas Southwestern Medical Center at Dallas conducted a double-blind study of 50 subjects with type 1 diabetes and a baseline body mass index (BMI) of 27.
They were randomized to receive insulin and rosiglitazone or insulin and placebo. The insulin regimen and dosage was adjusted to achieve near-normal glucose levels.
Over the 8-month study period, subjects in both groups showed a weight gain of about 3 kg, but both groups experienced a significant reduction in HbA1c level. This fell to 7.9% in the rosiglitazone group and to 7.7% in the placebo group.
Among the rosiglitazone subjects, 36% achieved an HbA1c between 6.0% and 6.5%. This was the case in 16% of the placebo group.
Both diastolic and systolic blood pressure fell in the rosiglitazone group. There was no change in the placebo group.
Summing up, Ms Strowig added that "rosiglitazone might be an effective adjunct to insulin treatment in individuals with type 1 diabetes who have markers of insulin resistance such as a BMI over 30, large total daily insulin doses, and high LDL cholesterol levels."
"However, since rosiglitazone can increase the potential for edema, mild anemia, and hypoglycemia, rosiglitazone should be considered only after efforts at intensifying insulin treatment, increasing blood glucose self-monitoring by the patient, and dietary management do not result in desired blood glucose goals."
Diabetes Care 2005;28:1562-1567.
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