Insulin Glargine vs. Rosiglitazone as Add-On Therapy in Type 2 Diabetes

When patients with type 2 diabetes have inadequate glycemic control on two oral drugs, one can add either a third oral drug or insulin. In this randomized trial — funded by the maker of insulin glargine (Lantus) — researchers compared the two strategies in 217 patients with glycosylated hemoglobin (HbA_1c) levels of 7.5% to 11%, despite treatment with a sulfonylurea and maximal-dose metformin.

Patients received either insulin glargine (starting at 10 units daily and titrating upward) or rosiglitazone (up to 8 mg daily), while continuing treatment with metformin and sulfonylurea. After 24 weeks, the mean declines in HbA_1c were similar in the insulin and rosiglitazone groups (1.7% and 1.5%). Hypoglycemia occurred slightly more frequently among …