Comparison of repaglinide and metformin monotherapy as an initial therapy in Chinese patients with newly diagnosed type 2 diabetes mellitus

Background: We aimed to compare the effect of repaglinide and metformin monotherapy as an initial therapy in Chinese patients with newly diagnosed type 2 diabetes mellitus (T2DM). Patients and methods: In this 15-week, open-labelled, parallel-controlled, randomised study, 60 Chinese drug-naive patients with newly diagnosed T2DM were randomised (2:1) to receive repaglinide or metformin monotherapy. Primary endpoint was change in HbA1c from baseline to the end of the trial. Secondary endpoints included changes in glycaemic variability, insulin sensitivity and b-cell function. Results: Patients in both repaglinide and metformin groups achieved significant reductions in HbA1c (K1.8G1.5 vs K1.6G1.5%), FPG (fasting blood glucose) (K1.7G1.7 vs K2.1G1.7 mmol/l) and 2-h PPG (post-prandial glucose) (K3.8G3.1 vs K3.8G3.6 mmol/l), with no statistical differences between the groups. Glycaemic variability, glucose infusion rate andb-cell function were all significantly improved from baseline in the two groups (all P!0.05), without any statistical differences in the improvement between the groups. Conclusions: Repaglinide and metformin achieved comparable efficacy in improving glycaemic control, reducing glycaemic variability, enhancing insulin sensitivity and ameliorating b-cell function. Therefore, repaglinide is an optional agent for initial therapy in Chinese patients with newly diagnosed T2DM.