OBJECTIVE -The purpose of this study was to determine the efficacy and safety of a novel extended-release metformin in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS -Adults with type 2 diabetes (newly diagnosed, treated with diet and exercise only, or previously treated with oral diabetic medications) were randomly assigned to receive one of three extended-release metformin treatment regimens (1,500 mg/day q.d., 1,500 mg/day twice daily, or 2,000 mg/day q.d.) or immediate-release metformin (1,500 mg/day twice daily) in a double-blind 24-week trial.RESULTS -Significant decreases (P Ͻ 0.001) in mean HbA 1c (A1C) levels were observed by week 12 in all treatment groups. The mean changes from baseline to end point in the two groups given 1,500 mg extended-release metformin (Ϫ0.73 and Ϫ0.74%) were not significantly different from the change in the immediate-release metformin group (Ϫ0.70%), whereas the 2,000-mg extended-release metformin group showed a greater decrease in A1C levels (Ϫ1.06%; mean difference [2,000 mg extended-release metformin Ϫ immediate-release metformin]: Ϫ0.36 [98.4% CI Ϫ0.65 to Ϫ0.06]). Rapid decreases in fasting plasma glucose levels were observed by week 1, which continued until week 8, and were maintained for the duration of the study. The overall incidence of adverse events was similar for all treatment groups, but fewer patients in the extended-release metformin groups discontinued treatment due to nausea during the initial dosing period than in the immediate-release metformin group. CONCLUSIONS -Once-or twice-daily extended-release metformin was as safe and effective as twice-daily immediate-release metformin and provided continued glycemic control for up to 24 weeks of treatment. Diabetes Care 29:759 -764, 2006M etformin hydrochloride has been widely used as an effective and generally well-tolerated glucoselowering agent for Ͼ40 years and is the most frequently prescribed first-line therapy for patients with type 2 diabetes (1). Metformin typically reduces basal and postprandial hyperglycemia by ϳ25% in Ͼ90% of patients when given alone or with other therapies during a program of managed care (2). In the U.K. Prospective Diabetes Study, intensive glucose control with metformin appeared to reduce the risk of diabetes-related end points in overweight patients and was associated with less weight gain and fewer hypoglycemic attacks than insulin (3).The objective of this study was to evaluate the efficacy, tolerability, and safety of a novel extended-release oral formulation of metformin compared with conventional immediate-release metformin during 24 weeks of double-blind treatment. When administered with food, the extended-release metformin tablet gradually releases drug over 8 h into the upper gastrointestinal tract (4), where metformin is primarily absorbed (5). Prolonged release of metformin from extended-release metformin tablets has been demonstrated in pharmacokinetic studies (6,7). Extended-release metformin showed slightly lower maximum concentrations, longer times to maxi...

Gabapentin ER administered twice daily is effective and safe for the treatment of pain associated with postherpetic neuralgia.

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