title: Effects of rosiglitazone, glyburide, and metformin on β-cell function and insulin sensitivity in ADOPT.
abstract: OBJECTIVE
  ADOPT (A Diabetes Outcome Progression Trial) demonstrated that initial monotherapy with rosiglitazone provided superior durability of glycemic control compared with metformin and glyburide in patients with recently diagnosed type 2 diabetes. Herein, we examine measures of β-cell function and insulin sensitivity from an oral glucose tolerance test (OGTT) over a 4-year period among the three treatments.
  
  
  METHODS
  Recently diagnosed, drug-naïve patients with type 2 diabetes (4,360 total) were treated for a median of 4.0 years with rosiglitazone, metformin, or glyburide and were examined with periodic metabolic testing using an OGTT.
  
  
  RESULTS
  Measures of β-cell function and insulin sensitivity from an OGTT showed more favorable changes over time with rosiglitazone versus metformin or glyburide. Persistent improvements were seen in those who completed 4 years of monotherapy and marked deterioration of β-cell function in those who failed to maintain adequate glucose control with initial monotherapy.
  
  
  CONCLUSIONS
  The favorable combined changes in β-cell function and insulin sensitivity over time with rosiglitazone appear to be responsible for its superior glycemic durability over metformin and glyburide as initial monotherapy in type 2 diabetes.
authors.affiliation: Department of Medicine, Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, Washington, USA. skahn@u.washington.edu
authors.forename: Steven E
authors.initials: SE
authors.lastname: Kahn
authors.forename: John M
authors.initials: JM
authors.lastname: Lachin
authors.forename: Bernard
authors.initials: B
authors.lastname: Zinman
authors.forename: Steven M
authors.initials: SM
authors.lastname: Haffner
authors.forename: R Paul
authors.initials: RP
authors.lastname: Aftring
authors.forename: Gitanjali
authors.initials: G
authors.lastname: Paul
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Kravitz
authors.forename: William H
authors.initials: WH
authors.lastname: Herman
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Viberti
authors.forename: Rury R
authors.initials: RR
authors.lastname: Holman
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005905:Glyburide / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance / Q000502:physiology; D050417:Insulin-Secreting Cells / Q000187:drug effects*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D008687:Metformin; D005905:Glyburide