Combination of insulin and thiazolidinedione therapy in massively obese patients with Type 2 diabetes

Diabet Med. 2002 Jul;19(7):572-4. doi: 10.1046/j.1464-5491.2002.00734.x.


Aims: To evaluate the influence of addition of rosiglitazone to insulin therapy over a 24-week period in massively obese patients with poorly controlled Type 2 diabetes taking large doses of insulin.

Methods: Eight massively obese patients (median body mass index (BMI) 42 kg/m2) with Type 2 diabetes who were on large doses of insulin (median daily dose of 204 U) and/or had poor glycaemic control (median HbA1c of 8.1% (upper limit for normal 5.5%)) were treated over a 24-week period with the combination of insulin and maximum doses of rosiglitazone. Outcomes monitored were changes in weight, BMI, HbA1c, dose of insulin and development of side-effects.

Results: At the end of 24 weeks there was a median weight gain of 3 kg (P < 0.01), a fall in median HbA1c from 8.1% to 6.7% (16% reduction from baseline) (P < 0.01) and a reduction in median insulin dose from 204 U/day to 159 U/day (P < 0.01) (23% reduction from baseline). Peripheral oedema was the only significant side-effect and was seen in five patients.

Conclusions: Combination of insulin and rosiglitazone is effective in massively obese patients with Type 2 diabetes, though there is a high incidence of peripheral oedema.

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Body Weight / drug effects
  • Diabetes Complications*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Drug Therapy, Combination
  • Edema / etiology
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / adverse effects
  • Insulin / therapeutic use*
  • Male
  • Middle Aged
  • Obesity*
  • Rosiglitazone
  • Thiazoles / therapeutic use*
  • Thiazolidinediones*


  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • Thiazoles
  • Thiazolidinediones
  • Rosiglitazone
  • 2,4-thiazolidinedione