New Type 2 Diabetes Drug Delays Disease Progression

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More than 20 million people in the United States have type 2 diabetes, the most common form of the disease. People with this condition either don't produce enough insulin, or cells in the body don't utilize the hormone efficiently. Insulin is essential for transporting sugar from the blood to cells for energy. Keeping blood sugar levels normal or nearly normal is critical to reducing the risk of the long-term complications of diabetes such as heart disease, nerve damage, kidney damage, blindness and amputations.

According to an accompanying editorial in the journal, the approval of five new classes of anti-diabetes drugs in the past decade has left doctors unsure of which to use first or how to combine them with other drugs. In particular, it hasn't been clear how the class of drugs known as thiazolidenediones, which includes Avandia and muraglitazar, compare with other glucose-lowering medications. These drugs work by sensitizing muscle, liver and fat tissue to insulin.

This study compared 4,360 newly diagnosed type 2 diabetes patients receiving either Avandia (rosiglitazone, a thiazoidinedione made by GlaxoSmithKline); glyburide (Micronase); or metformin (Glucophage). Prior to the study, participants had not taken any medications for diabetes.

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The trial was sponsored by Glaxo, and study lead author Dr. Steven Kahn disclosed having served as a consultant and speaker for the company.

Avandia delayed the need for additional drugs by 60 months, compared with 45 months for Glucophage and 33 months for Micronase.

Participants taking Avandia had more weight gain and edema while participants on Micronase had a lower risk of cardiovascular events. One unexpected finding was that women taking Avandia had more fractures, primarily in the hands and feet.

A surprisingly high proportion of participants dropped out of the study, the editorial pointed out.

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