Background: Few studies have examined the efficacy and safety of thiazolidinedione use in patients with diabetic nephropathy. Our goal was to examine the metabolic effects and tolerability of combination therapy with rosiglitazone and insulin in type 2 diabetic patients with nephropathy and renal failure.
Material/methods: We evaluated the metabolic effects and tolerability of rosiglitazone as an add-on therapy to insulin in 12 Chinese type 2 diabetic patients (5 males and 7 females) with nephropathy and renal impairment. The mean age of these patients was 65+/-8.3 years, and the mean duration of disease was 16.5+/-8.6 years. The initial daily dosage of rosiglitazone, 2 mg daily, was increased to 4 mg if their fasting plasma glucose concentrations were above 10 mmol/L after 4 weeks.
Results: Over a mean period of 15.5 months, HbA1c improved significantly following the addition of rosiglitazone, from 8.57+/-1.42% to 7.48+/-1.3% (p=0.01). There was a trend towards improved lipid profile with this combination therapy, but it was not statistically significant. There was no major adverse events except for minimal weight gain (71.7+/-13.6 kg vs 73.9+/-13.1 kg, p=0.08).
Conclusions: Combination therapy with rosiglitazone and insulin has beneficial metabolic effects and is generally well tolerated in type 2 diabetic patients with nephropathy and mild to moderate renal failure.