Professor Giancarlo Viberti of King's has announced today (4 December) the results of a major international clinical trial comparing the efficacy of three drugs currently being used to treat Type 2 diabetes. The findings show that the most expensive drug, rosiglitazone, slowed the progression of the disease longer than the other drugs, metformin and glyburide.
(Media-Newswire.com) - Speaking at the 19th World Diabetes Congress in Cape Town, South Africa, Giancarlo Viberti, Professor of Diabetes and Metabolic Medicine at King's, outlined the findings of the ADOPT study ( A Diabetes Outcome Progression Trial ). This includes research groups in the USA, Canada and 15 European countries. The study is published today in the New England Journal of Medicine.
The randomised, controlled trial evaluated the three drugs as an initial single treatment for Type 2 diabetes. 4360 patients, within three years of diagnosis and who had been on diet and lifestyle modifications only, were treated for up to six years ( average treatment length was four years ). The researchers studied the progression of the disease by measuring how long good glycaemic control was maintained.
People without diabetes typically have glycated haemoglobin ( HbA1c - an index of blood glucose control ) of 4.2 to 6.2 per cent. Diabetic patients are considered in good control when HbA1c is less than 7 per cent. In this trial, the patients taking rosiglitazone maintained this level for up to 60 months, those taking metformin maintained it for up to 45 months, while people who were given glyburide kept at this level for up to 36 months. Therefore, rosiglitazone gained 15 months of good glucose control compared to metformin.
Maintenance of good glucose control is important because it reduces the risk of long-term vascular complications of diabetes such as blindness, kidney failure, amputations, heart disease and stroke. These complications are the major contributor to the high cost of care for people with diabetes.
There are currently over two million people with diabetes in the UK. According to the World Health Organisation, more than 180 million worldwide have diabetes and the number is likely to more than double by 2030. 90 per cent of these cases will have Type 2 diabetes.
Side effects for all three drugs were also monitored. Rosiglitazone prompted weight gain, fluid retention and edema ( swollen legs ). Metformin produced no such complications but showed more gastrointestinal effects, in particular diarrhoea. There was no difference between these two drugs in cardiovascular events such as heart attack and stroke. The third drug, glyburide, had a much greater incidence of hypoglycaemia ( low blood glucose levels ).
Professor Giancarlo Viberti commented, ‘This important trial provides clear evidence that one drug crucially maintains glycaemic control over a considerably longer period. But the potential risks and benefits, the side-effects and the costs of these three drugs should now all be considered by clinicians and patients to help inform the choice of therapy for Type 2 diabetes.'
Professor Rury Holman of the Diabetes Trial Unit at Oxford University, and joint investigator for the UK study, added, ‘This is the first long-term, head-to-head evaluation comparing glyburide, metformin and rosiglitazone monotherapies. It provides valuable insight into the importance of modifying insulin sensitivity and insulin secretory function.'
Notes to editors The research was conducted by the ADOPT Study Group. In addition to King's College London School of Medicine this is led by: the University of Washington, University of Texas, University of Michigan, University of Oxford, George Washington University and the University of Toronto.
The trial was funded by GlaxoSmithKline. Study design, analysis, interpretation of the findings and decision to submit the paper for publication was under the supervision of an independent, academically-based steering committee.
King's College London King's College London is the fourth oldest university in England with more than 13,700 undergraduates and nearly 5,600 graduate students in nine schools of study based at five London campuses. It is a member of the Russell Group: a coalition of the UK's major research-based universities. The College has had 24 of its subject-areas awarded the highest rating of 5* and 5 for research quality, demonstrating excellence at an international level, and it has recently received an excellent result in its audit by the Quality Assurance Agency.
King's has a particularly distinguished reputation in the humanities, law, international relations, medicine, nursing and the sciences, and has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA. It is the largest centre for the education of healthcare professionals in Europe and is home to four Medical Research Council Centres – more than any other university.
King's is in the top group of UK universities for research earnings, with income from grants and contracts of more than £100 million, and has an annual turnover of more than £363 million.
The Diabetes Trials Unit, Oxford University The Diabetes Trials Unit ( DTU ) at Oxford University, founded in 1985 by Professor Rury Holman, is one of the largest clinical diabetes research groups in Europe. The DTU investigates the pathophysiology of Type 2 diabetes, evaluates potential therapeutic and preventative treatments, and runs several multi-centre clinical-outcome studies. It is based within OCDEM ( the Oxford Centre for Diabetes, Endocrinology and Metabolism ), a pioneering centre at Oxford University which combines clinical care, research and education in diabetes, endocrine and metabolic diseases. See www.dtu.ox.ac.ukwww.ocdem.ox.ac.uk
Further information Ruth Sargison, Public Relations Office, King's College London Tel: 020 7848 4334 Email: firstname.lastname@example.org
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