skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8852

Treatment update: thiazolidinediones in combination with metformin for the treatment of type 2 diabetes

Review

(2478) Views  (646) Full article downloads

Authors: John M Stafford, Tom Elasy

Published Date October 2007 Volume 2007:3(4) Pages 503 - 510
DOI: http://dx.doi.org/10.2147/VHRM.S936

John M Stafford1, Tom Elasy2

1Division of Diabetes Endocrinology and Metabolism, Vanderbilt University; 2Vanderbilt Eskind Diabetes Clinic, Vanderbilt University Medical Center

Abstract: Type 2 diabetes mellitus (DM2) is characterized by excessive hepatic gluconeogenesis, increased insulin resistance and a progressive inability of pancreatic beta cells to produce sufficient insulin. DM2 evolves as a progression from normal glucose tolerance, to impaired glucose tolerance (IGT) to frank diabetes mellitus, reflecting the establishment of insulin resistance and beta cell dysfunction. Insulin resistance not only contributes to impaired glycemic control in DM2, but to the development of hypertension, dyslipidemia and endothelial dysfunction. Cardiovascular disease is the primary morbidity for patients with DM2. The onset of insulin resistance and cardiovascular insult likely occurs well before the onset of IGT is detected clinically. Biguanides and thiazolidinediones (TZDs) are two classes of oral agents for the management of DM2 that improve insulin resistance, and thus have potential cardiovascular benefits beyond glycemic control alone. Metformin additionally inhibits hepatic gluconeogenesis. The combined use of two of these agents targets key pathophysiologic defects in DM2. Single pill combinations of rosiglitazone/metformin and pioglitazone/metformin have recently been approved for use in the US and Europe. This article reviews the clinical data behind the use of metformin in combination with TZDs for the management of diabetes, its impact on vascular health, side effects and potential mechanisms of action for combined use.

Keywords: thiazolidinediones; metformin; Type 2 diabetes








Readers of this article also read:

Prolonged-release nicotinic acid for the management of dyslipidemia: an update including results from the NAUTILUS study
Factor eight inhibitor bypass activity (FEIBA) in the management of bleeds in hemophilia patients with high-titer inhibitors
Apolipoproteins A-I and B: biosynthesis, role in the development of atherosclerosis and targets for intervention against cardiovascular disease
Current concepts in targeted therapies for the pathophysiology of diabetic microvascular complications
New combination treatments in the management of diabetes: focus on sitagliptin – metformin
Blood pressure reduction due to hemoglobin glycosylation in type 2 diabetic patients
Repaglinide/metformin fixed-dose combination to improve glycemic control in patients with type 2 diabetes: an update
Evidence-based approach for managing hypertension in type 2 diabetes
Clinical utility of fixed combinations of sitagliptin–metformin in treatment of type 2 diabetes
Physical growth in children with transfusion-dependent thalassemia
  • Join ISVH

    Be part of the World's leading experts in vascular health by joining the International Society of Vascular Health (ISVH)

  • Testimonials

    "... I was impressed at the rapidity of publication from submission to final acceptance." Dr Edwin Thrower, PhD, Yale University