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TORONTO | Results from A Diabetes Outcome Progression Trial (ADOPT) were met with both excitement and caution following their presentation at the International Diabetes Federation's World Diabetes Congress in Cape Town in early December.

The ADOPT study, funded by GlaxoSmithKline, was designed to compare the ability of rosiglitazone (Avandia), metformin and glyburide monotherapy to maintain long-term glycemic control in 4,360 recently diagnosed type II diabetes patients....

The original article can be found at: http://www.medicalpost.com/medicine/clinical/

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what we said (Hover the mouse cursor over underlined words for more info)

Unfortunately this article did not provide any information about the type of study design and benefits and harm in terms of absolute risk reductions which make it difficult to draw any firm conclusions. Also there is no information on the comparative costs of rosiglitazone, metformin and glyburide.

The incidence of adverse events potentially related to volume expansion, other than congestive heart failure (i.e. pulmonary oedema and pleural effusions) has not been reported. Also, the clinical significance of the statistically higher rate of weight gain and fluid retention with rosiglitazone compared to metformin and glyburide in terms of mortality or morbidity over five year period of this study is not clear. It seems that something wrong is going on with rosiglitazone which longer prospective studies are needed to assess the impact and extent of the problem. There is no mention of the rate of hypoglycemia or other serious adverse events with 3 arms of this study. This story should have more clear emphasis on these points as its main massage for the readers.

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