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Abstract
- In patients with type 2
diabetes treated with
insulin, adding metformin
improves the glycated
haemoglobin (HbA1c)
level and reduces weight gain, without
increasing the risk of hypoglycaemia.
- According to the Summaries of Product
Characteristics (SPC), glitazone in combination
with insulin used to be contraindicated
because of an increased risk
of heart failure. This contraindication was
removed in 2007.
- Yet there are still no data conclusively
demonstrating that glitazones prevent
clinical complications of diabetes.
- In contrast, an increased risk
of adverse effects due to water-sodium
retention, including heart failure, weight
gain and peripheral oedema, has been
confirmed in patients treated with pioglitazone
plus insulin rather than with insulin
alone. There have been similar reports
in patients treated with rosiglitazone plus
insulin.