Nateglinide alone or with metformin safely improves glycaemia to target in patients up to an age of 84

Authors: Weaver, J. U.¹; Robertson, D.²; Atkin, S. L.³

Source: Diabetes, Obesity and Metabolism, Volume 6, Number 5, September 2004 , pp. 344-352(9)

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Abstract:

Aim:

To assess the effect of nateglinide on efficacy [fasting plasma glucose (FPG), postprandial plasma glucose (PPG) plasma glucose and HbA1c], tolerability and safety in patients with type 2 diabetes mellitus (T2Dm) on diet alone or on metformin in subjects up to an age of 84. Methods:

In an open-labelled 12-week, parallel study of 358 patients, aged 35-84 years with T2Dm, nateglinide was given as either monotherapy in patients previously on diet alone or low-dose sulfonylureas, which required washout before the study (group 1), or as an addition therapy in patients on steady dose of metformin (group 2). Nateglinide 120 mg was given before main meals. HbA1c, FPG and PPG values were taken at the time of breakfast at the beginning and the end of the study. Results:

HbA1c fell by a mean of 0.83%, 95% confidence interval (CI) (−0.97, −0.69) (p < 0.001) in group 1, and 0.67%, 95% CI (−0.77, −0.58) (p < 0.001) in group 2. There was a significant improvement in PPG in group 1 by a mean reduction of −3.47 mmol/l, 95% CI (−4.08, −2.87) (p < 0.0001) and in group 2 of −2.41 mmol/l, 95% CI (−2.84, −1.99) (p < 0.0001). There was an improvement in FPG of −1.2 mmol/l, 95% CI (−1.49, −0.81) (p < 0.0001) and −0.8 mmol/l, 95% CI -(1.07, −0.53) (p < 0.0001) in group 1 and 2 respectively. 44% of patients in group 1 and 34% in group 2 achieved target of HbA1c <7.0 and 66% in group 1 and 59% in group 2 achieved of HbA1c <7.5%. Only one subject on nateglinide and metformin was withdrawn due to the side effect of hypoglycaemia. No patient required third-party assistance nor was admitted to hospital due to hypoglycaemia. Conclusion:

These data demonstrate that nateglinide is a safe and effective agent in treatment to target in patients with T2Dmup to an age of 84 years.

Keywords: first-phase insulin secretion; hypoglycaemia; postprandial plasma glucose; prospective study; type 2 diabetes mellitus

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1462-8902.2004.00353.x

Affiliations: 1: Queen Elizabeth Hospital, University of Newcastle-upon-Tyne, Tyne and Wear, UK 2: Sandwell General Hospital, West Bromwich, West Midlands, UK 3: Hull Royal Infirmary, University of Hull, Hull, UK

Publication date: 2004-09-01

Nateglinide alone or with metformin safely improves glycaemia to target in patients up to an age of 84

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