Combination Therapy With Nateglinide and a Thiazolidinedione Improves Glycemic Control in Type 2 Diabetes

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Abstract
OBJECTIVE—To compare the effects of monotherapy using nateglinide and the thiazolidinedione troglitazone with initial combination of the two agents on glycated hemoglobin (HbA1c) in patients with type 2 diabetes inadequately controlled by diet alone. RESEARCH DESIGN AND METHODS—This study consisted of a 28-week, double-blind, randomized, multicenter study that included a 4-week, single-blind, placebo, run-in period and a 24-week (shortened to 16 weeks), double-blind, active treatment period. RESULTS—At the 16-week end point, nateglinide 120 mg, troglitazone 600 mg, and the combination of the agents achieved statistically significant decreases in HbA1c in comparison with placebo and a baseline HbA1c of 8.1–8.4% (P < 0.001). The reductions in HbA1c were similar in the nateglinide (0.6%) and troglitazone (0.8%) monotherapy groups. The reduction in HbA1c (1.7%) was greatest in the combination group; 79% of patients in the combination group achieved HbA1c levels of 1c levels. However, these reductions from baseline HbA1c values of >8% are not adequate to achieve HbA1c levels of 1c levels to the target of 1c that is just above 8%.