AbstractObjective: To determine the effect of treatment with insulin Aspart as compared to NPH insulin, together with metformin/placebo and rosiglitazone/placebo. The hypothesis was that combined correction of major pathogenetic defects in type 2 diabetes would result in optimal glycemic control. Research Design and Methods: A 2-year investigator driven, randomized, partly placebo controlled, multicenter trial in 371 patients with type 2 diabetes on at least oral antiglycemic treatment. Patients were assigned to one of eight treatment groups in a factorial design with insulin aspart at mealtimes vs. NPH insulin once daily at bedtime, metformin twice daily vs. placebo, and rosiglitazone twice daily vs placebo. Main outcome measurement: change in HbA1c. Results: HbA1c decreased more in patients treated with insulin aspart compared to NPH (-0.41 ± 0.10%,
