title: Combination of insulin and thiazolidinedione therapy in massively obese patients with Type 2 diabetes.
abstract: OBJECTIVE
  To evaluate the influence of addition of rosiglitazone to insulin therapy over a 24-week period in massively obese patients with poorly controlled Type 2 diabetes taking large doses of insulin.
  
  
  METHODS
  Eight massively obese patients (median body mass index (BMI) 42 kg/m2) with Type 2 diabetes who were on large doses of insulin (median daily dose of 204 U) and/or had poor glycaemic control (median HbA1c of 8.1% (upper limit for normal 5.5%)) were treated over a 24-week period with the combination of insulin and maximum doses of rosiglitazone. Outcomes monitored were changes in weight, BMI, HbA1c, dose of insulin and development of side-effects.
  
  
  RESULTS
  At the end of 24 weeks there was a median weight gain of 3 kg (P < 0.01), a fall in median HbA1c from 8.1% to 6.7% (16% reduction from baseline) (P < 0.01) and a reduction in median insulin dose from 204 U/day to 159 U/day (P < 0.01) (23% reduction from baseline). Peripheral oedema was the only significant side-effect and was seen in five patients.
  
  
  CONCLUSIONS
  Combination of insulin and rosiglitazone is effective in massively obese patients with Type 2 diabetes, though there is a high incidence of peripheral oedema.
authors.affiliation: Wolverhampton Diabetes Centre, New Cross Hospital, UK.
authors.forename: H N
authors.initials: HN
authors.lastname: Buch
authors.forename: V
authors.initials: V
authors.lastname: Baskar
authors.forename: D M
authors.initials: DM
authors.lastname: Barton
authors.forename: D
authors.initials: D
authors.lastname: Kamalakannan
authors.forename: C
authors.initials: C
authors.lastname: Akarca
authors.forename: B M
authors.initials: BM
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004487:Edema / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity; D000077154:Rosiglitazone; D013844:Thiazoles / Q000627:therapeutic use*; D045162:Thiazolidinediones
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D000077154:Rosiglitazone; D013844:Thiazoles; D045162:Thiazolidinediones; C089946:2,4-thiazolidinedione