When combined with NPH insulin taken at bedtime, Glucophage (metformin) provides slightly better glucose control with less weight gain and improved satisfaction with diabetes treatment than Prandin (repaglinide) plus NPH, say researchers in the United Kingdom.
Eighty subjects with type 2 diabetes who took both Glucophage and nighttime NPH insulin were randomly assigned either to 13 weeks of treatment with 4 mg of Prandin taken twice a day or to treatment with their usual dose of Glucophage. In both groups, insulin doses were adjusted to aim for a fasting blood-glucose level of 108 mg/dl.
Blood glucose control improved marginally in the group that took Glucophage plus bedtime insulin, with a corresponding 0.45 percent drop in A1C levels, from an average of 8.4% to 8.1%. A1C levels deteriorated in the group that took Prandin along with bedtime insulin, increasing 0.4 percent, from an average of 8.1% to 8.6%. Those on Glucophage gained an average of about 2 pounds, whereas the group that took Prandin gained nearly 6 pounds on average. Frequency of hypoglycemia was similar for both treatments, and all episodes were mild and self-treated.
On a scale of 0 to 36, diabetes treatment satisfaction rose from 32.4 to 34.1 in the Glucophage group and decreased from 32.5 to 29.1 in the Prandin group.
-Diabetes Care, October 2002