Elsevier

The Lancet

Volume 368, Issue 9541, 23–29 September 2006, Pages 1096-1105
The Lancet

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Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial

https://doi.org/10.1016/S0140-6736(06)69420-8Get rights and content
open access

Summary

Background

Rosiglitazone is a thiazolidinedione that reduces insulin resistance and might preserve insulin secretion. The aim of this study was to assess prospectively the drug's ability to prevent type 2 diabetes in individuals at high risk of developing the condition.

Methods

5269 adults aged 30 years or more with impaired fasting glucose or impaired glucose tolerance, or both, and no previous cardiovascular disease were recruited from 191 sites in 21 countries and randomly assigned to receive rosiglitazone (8 mg daily; n=2365) or placebo (2634) and followed for a median of 3 years. The primary outcome was a composite of incident diabetes or death. Analyses were done by intention to treat. This trial is registered at ClinicalTrials.gov, number NCT00095654.

Findings

At the end of study, 59 individuals had dropped out from the rosiglitazone group and 46 from the placebo group. 306 (11·6%) individuals given rosiglitazone and 686 (26·0%) given placebo developed the composite primary outcome (hazard ratio 0·40, 95% CI 0·35–0·46; p<0·0001); 1330 (50·5%) individuals in the rosiglitazone group and 798 (30·3%) in the placebo group became normoglycaemic (1·71, 1·57–1·87; p<0·0001). Cardiovascular event rates were much the same in both groups, although 14 (0·5%) participants in the rosiglitazone group and two (0·1%) in the placebo group developed heart failure (p=0·01).

Interpretation

Rosiglitazone at 8 mg daily for 3 years substantially reduces incident type 2 diabetes and increases the likelihood of regression to normoglycaemia in adults with impaired fasting glucose or impaired glucose tolerance, or both.

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Group members are listed at the end of the report