In this small placebo-controlled single-blind crossover study of subjects with Type 2 DM, exendin-4, vs placebo, was more effective at lowering post-prandial blood glucose levels. In fasting subjects, a dose-dependent rise in insulin concentrations was demonstrated. The short duration of the study (five days), the DOE outcomes (blood glucose levels), and the lack of sufficient power to examine either short or long-term outcomes (either beneficial or hazardous) limits the conclusions that may be drawn regarding use of this agent. We estimated that a 12 day supply to the patient would (at current cost) cost approximately $200.00. Practitioners should await larger, longer and patient-oriented studies before changing their current practice re: diabetes care.

Metformin treatment for six months was significantly more effective than six-cycles of clomiphene citrate in improving fertility in non-obese anovulatory women with PCOS. This outcome occurred despite the fact that improvement in ovulation rates was similar between the two groups. Adverse event rates were similar. NNT of -3 indicates that for each 3 women treated, one less woman will remain infertile after six months of treatment. The relative risk of remaining anovulatory was reduced by approximately 80 percent. In the metformin-treated group, the cumulative rate rate of pregancy continued to increase with each subsequent cycle, whereas in the clomiphene group, it plateaued. This treatment strategy may be useful to primary care physicians wishing to help their PCOS patients achieve fertility, with possibly less risk of hyperstimulation of ovulation (risk of multiple gestation pregnancies.) Results from this study may not be extrapolatable to obese (BMI > 30) women with PCOS.

For laboring women with thick meconium staining of amniotic fluid, amnioinfusion did not reduce the risk of perinatal death, moderate or severe meconium aspiration syndrome, or both. The study was adequately powered at the 80% level to detect a decrease in the expected outcome from 5% to 2.5%.