Impact of bromocriptine-QR therapy on glycemic control and daily insulin requirement in type 2 diabetes mellitus subjects whose dysglycemia is poorly controlled on high-dose insulin: A pilot study

Background. the concurrent use of a postprandial insulin sensitizing agent,such as bromocriptine-qr,a quick release formulation of bromocriptine,a dopamine d2 receptor agonist,may offer a strategy to improve glycemic control and limit/reduce insulin requirement in type 2 diabetes (t2dm) patients on high-dose insulin. this open label pilot study evaluated this potential utility of bromocriptine-qr. methods: ten t2dm subjects on metformin (1-2gm/day) and high-dose (tdid ≥ 65u/day) basal-bolus insulin were enrolled to receive once daily (morning) bromocriptine-qr (1.6-4.8 mg/day) for 24 weeks. subjects with at least one postbaseline hba1c measurement (n = 8) were analyzed for change from baseline hba1c,tdid,and postprandial glucose area under the curve of a four-hour mixed meal tolerance test (mmtt). results: compared to the baseline,average hba1cdecreased 1.76% (9.74 ± 0.56 to 7.98 ± 0.36,= 0.01),average tdid decreased 27% (199 ± 33 to 147 ± 31,p = 0.009),and mmtt auc60-240decreased 32% (p = 0.04) over the treatment period. the decline in hba1cand tdid was observed at 8 weeks and sustained over the remaining 16-week study duration. conclusion: in this study,bromocriptine-qr therapy improved glycemic control and meal tolerance while reducing insulin requirement in t2dm subjects poorly controlled on high-dose insulin therapy. copyright © 2015 erin d. roe et al.