title: Impact of Bromocriptine-QR Therapy on Glycemic Control and Daily Insulin Requirement in Type 2 Diabetes Mellitus Subjects Whose Dysglycemia Is Poorly Controlled on High-Dose Insulin: A Pilot Study.
abstract: BACKGROUND
  The concurrent use of a postprandial insulin sensitizing agent, such as bromocriptine-QR, a quick release formulation of bromocriptine, a dopamine D2 receptor agonist, may offer a strategy to improve glycemic control and limit/reduce insulin requirement in type 2 diabetes (T2DM) patients on high-dose insulin. This open label pilot study evaluated this potential utility of bromocriptine-QR.
  
  
  METHODS
  Ten T2DM subjects on metformin (1-2 gm/day) and high-dose (TDID ≥ 65 U/day) basal-bolus insulin were enrolled to receive once daily (morning) bromocriptine-QR (1.6-4.8 mg/day) for 24 weeks. Subjects with at least one postbaseline HbA1c measurement (N = 8) were analyzed for change from baseline HbA(1c), TDID, and postprandial glucose area under the curve of a four-hour mixed meal tolerance test (MMTT).
  
  
  RESULTS
  Compared to the baseline, average HbA1c decreased 1.76% (9.74 ± 0.56 to 7.98 ± 0.36, P = 0.01), average TDID decreased 27% (199 ± 33 to 147 ± 31, P = 0.009), and MMTT AUC(60-240) decreased 32% (P = 0.04) over the treatment period. The decline in HbA(1c) and TDID was observed at 8 weeks and sustained over the remaining 16-week study duration.
  
  
  CONCLUSIONS
  In this study, bromocriptine-QR therapy improved glycemic control and meal tolerance while reducing insulin requirement in T2DM subjects poorly controlled on high-dose insulin therapy.
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.
authors.forename: Erin D
authors.initials: ED
authors.lastname: Roe
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Bindu
authors.initials: B
authors.lastname: Chamarthi
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Raskin
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001971:Bromocriptine / Q000008:administration & dosage / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D018491:Dopamine Agonists; D007004:Hypoglycemic Agents; D007328:Insulin; D001971:Bromocriptine; D008687:Metformin