Glycemic and non-glycemic effects of pioglitazone in triple oral therapy in patients with type 2 diabetes mellitus

M Dorkhan; Martin Magnusson; A Frid; A Grubb; L Groop; S Jovinge

doi:10.1111/j.1365-2796.2006.01665.x

Glycemic and non-glycemic effects of pioglitazone in triple oral therapy in patients with type 2 diabetes mellitus

M Dorkhan, Martin Magnusson, A Frid, A Grubb, L Groop, S Jovinge

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Abstract

OBJECTIVES: To examine pioglitazone as add-on to metformin and insulin secretagogues in patients with type 2 diabetes and inadequate glycaemic control and its effect on glycaemic control, surrogate measures of insulin sensitivity (adiponectin) and beta-cell function (proinsulin/insulin) and fluid retention.

DESIGN AND SETTING: Prospective open-label study of 54 patients with type 2 diabetes and HbA1c>or=6.5% admitted to outpatient unit at Malmö University Hospital. The patients received 30-45 mg pioglitazone daily during 26 weeks in addition to their existing antidiabetic medication. After 26 weeks, one-third of patients were followed for 3 months without pioglitazone.

RESULTS: HbA1c decreased (7.8+/-0.9-6.3+/-0.9%, P<0.001) with 61% of patients achieving levels<6.5%. However, in the group followed for another 3 months HbA1c increased (6.1+/-0.73-7.1+/-0.9, n=18, P<0.001) after pioglitazone withdrawal. Adiponectin increased (6.1+/-2.8-13.2+/-5.8 microg mL-1, P<0.001) and the proinsulin to insulin ratio decreased (0.89+/-0.66-0.66+/-0.53, P<0.001). Nt-proBNP increased from 487.3+/-252.2 to 657.8+/-392.1 pmol L-1 (P<0.001).

CONCLUSIONS: Pioglitazone is effective in achieving glycaemic targets and reducing risk factors involved in atherosclerosis and improving beta-cell function when used as part of triple oral therapy in patients with type 2 diabetes and secondary drug failure. Nt-proBNP increase with concomitant decrease in haemoglobin suggests a subclinical sign of fluid retention.

Original language	English
Pages (from-to)	125-133
Number of pages	9
Journal	Journal of Internal Medicine
Volume	260
Issue number	2
DOIs	https://doi.org/10.1111/j.1365-2796.2006.01665.x
Publication status	Published - 2006 Aug

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Pediatrics/Urology/Gynecology/Endocrinology (013240400), Hematopoietic Stem Cell Laboratory (013022012), Division of Clinical Chemistry and Pharmacology (013250300), Diabetes and Endocrinology (013241530)

Subject classification (UKÄ)

Cardiology and Cardiovascular Disease
Medicinal Chemistry
Endocrinology and Diabetes

Free keywords

Adiponectin
Administration, Oral
Aged
Biomarkers
Blood Glucose
Case-Control Studies
Cystatin C
Cystatins
Diabetes Mellitus, Type 2
Drug Therapy, Combination
Female
Glyburide
Hemoglobin A, Glycosylated
Humans
Hypoglycemic Agents
Insulin
Male
Metformin
Middle Aged
Natriuretic Peptide, Brain
Peptide Fragments
Proinsulin
Prospective Studies
Statistics, Nonparametric
Thiazolidinediones
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/j.1365-2796.2006.01665.x

DorkhanBlackwell

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16882276&dopt=Abstract

1 Doctoral Thesis (compilation)

Assessment and Treatment of Impaired Insulin- Secretion and Action in Type 2 Diabetes
Dorkhan, M., 2008, Department of Clinical Sciences, Lund University. 124 p.
Research output: Thesis › Doctoral Thesis (compilation)

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Cite this

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title = "Glycemic and non-glycemic effects of pioglitazone in triple oral therapy in patients with type 2 diabetes mellitus",

abstract = "OBJECTIVES: To examine pioglitazone as add-on to metformin and insulin secretagogues in patients with type 2 diabetes and inadequate glycaemic control and its effect on glycaemic control, surrogate measures of insulin sensitivity (adiponectin) and beta-cell function (proinsulin/insulin) and fluid retention.DESIGN AND SETTING: Prospective open-label study of 54 patients with type 2 diabetes and HbA1c>or=6.5% admitted to outpatient unit at Malm{\"o} University Hospital. The patients received 30-45 mg pioglitazone daily during 26 weeks in addition to their existing antidiabetic medication. After 26 weeks, one-third of patients were followed for 3 months without pioglitazone.RESULTS: HbA1c decreased (7.8+/-0.9-6.3+/-0.9%, P<0.001) with 61% of patients achieving levels<6.5%. However, in the group followed for another 3 months HbA1c increased (6.1+/-0.73-7.1+/-0.9, n=18, P<0.001) after pioglitazone withdrawal. Adiponectin increased (6.1+/-2.8-13.2+/-5.8 microg mL-1, P<0.001) and the proinsulin to insulin ratio decreased (0.89+/-0.66-0.66+/-0.53, P<0.001). Nt-proBNP increased from 487.3+/-252.2 to 657.8+/-392.1 pmol L-1 (P<0.001).CONCLUSIONS: Pioglitazone is effective in achieving glycaemic targets and reducing risk factors involved in atherosclerosis and improving beta-cell function when used as part of triple oral therapy in patients with type 2 diabetes and secondary drug failure. Nt-proBNP increase with concomitant decrease in haemoglobin suggests a subclinical sign of fluid retention.",

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author = "M Dorkhan and Martin Magnusson and A Frid and A Grubb and L Groop and S Jovinge",

note = "The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pediatrics/Urology/Gynecology/Endocrinology (013240400), Hematopoietic Stem Cell Laboratory (013022012), Division of Clinical Chemistry and Pharmacology (013250300), Diabetes and Endocrinology (013241530)",

year = "2006",

month = aug,

doi = "10.1111/j.1365-2796.2006.01665.x",

language = "English",

volume = "260",

pages = "125--133",

journal = "Journal of Internal Medicine",

issn = "1365-2796",

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TY - JOUR

T1 - Glycemic and non-glycemic effects of pioglitazone in triple oral therapy in patients with type 2 diabetes mellitus

AU - Dorkhan, M

AU - Magnusson, Martin

AU - Frid, A

AU - Grubb, A

AU - Groop, L

AU - Jovinge, S

N1 - The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pediatrics/Urology/Gynecology/Endocrinology (013240400), Hematopoietic Stem Cell Laboratory (013022012), Division of Clinical Chemistry and Pharmacology (013250300), Diabetes and Endocrinology (013241530)

PY - 2006/8

Y1 - 2006/8

N2 - OBJECTIVES: To examine pioglitazone as add-on to metformin and insulin secretagogues in patients with type 2 diabetes and inadequate glycaemic control and its effect on glycaemic control, surrogate measures of insulin sensitivity (adiponectin) and beta-cell function (proinsulin/insulin) and fluid retention.DESIGN AND SETTING: Prospective open-label study of 54 patients with type 2 diabetes and HbA1c>or=6.5% admitted to outpatient unit at Malmö University Hospital. The patients received 30-45 mg pioglitazone daily during 26 weeks in addition to their existing antidiabetic medication. After 26 weeks, one-third of patients were followed for 3 months without pioglitazone.RESULTS: HbA1c decreased (7.8+/-0.9-6.3+/-0.9%, P<0.001) with 61% of patients achieving levels<6.5%. However, in the group followed for another 3 months HbA1c increased (6.1+/-0.73-7.1+/-0.9, n=18, P<0.001) after pioglitazone withdrawal. Adiponectin increased (6.1+/-2.8-13.2+/-5.8 microg mL-1, P<0.001) and the proinsulin to insulin ratio decreased (0.89+/-0.66-0.66+/-0.53, P<0.001). Nt-proBNP increased from 487.3+/-252.2 to 657.8+/-392.1 pmol L-1 (P<0.001).CONCLUSIONS: Pioglitazone is effective in achieving glycaemic targets and reducing risk factors involved in atherosclerosis and improving beta-cell function when used as part of triple oral therapy in patients with type 2 diabetes and secondary drug failure. Nt-proBNP increase with concomitant decrease in haemoglobin suggests a subclinical sign of fluid retention.

AB - OBJECTIVES: To examine pioglitazone as add-on to metformin and insulin secretagogues in patients with type 2 diabetes and inadequate glycaemic control and its effect on glycaemic control, surrogate measures of insulin sensitivity (adiponectin) and beta-cell function (proinsulin/insulin) and fluid retention.DESIGN AND SETTING: Prospective open-label study of 54 patients with type 2 diabetes and HbA1c>or=6.5% admitted to outpatient unit at Malmö University Hospital. The patients received 30-45 mg pioglitazone daily during 26 weeks in addition to their existing antidiabetic medication. After 26 weeks, one-third of patients were followed for 3 months without pioglitazone.RESULTS: HbA1c decreased (7.8+/-0.9-6.3+/-0.9%, P<0.001) with 61% of patients achieving levels<6.5%. However, in the group followed for another 3 months HbA1c increased (6.1+/-0.73-7.1+/-0.9, n=18, P<0.001) after pioglitazone withdrawal. Adiponectin increased (6.1+/-2.8-13.2+/-5.8 microg mL-1, P<0.001) and the proinsulin to insulin ratio decreased (0.89+/-0.66-0.66+/-0.53, P<0.001). Nt-proBNP increased from 487.3+/-252.2 to 657.8+/-392.1 pmol L-1 (P<0.001).CONCLUSIONS: Pioglitazone is effective in achieving glycaemic targets and reducing risk factors involved in atherosclerosis and improving beta-cell function when used as part of triple oral therapy in patients with type 2 diabetes and secondary drug failure. Nt-proBNP increase with concomitant decrease in haemoglobin suggests a subclinical sign of fluid retention.

KW - Adiponectin

KW - Administration, Oral

KW - Aged

KW - Biomarkers

KW - Blood Glucose

KW - Case-Control Studies

KW - Cystatin C

KW - Cystatins

KW - Diabetes Mellitus, Type 2

KW - Drug Therapy, Combination

KW - Female

KW - Glyburide

KW - Hemoglobin A, Glycosylated

KW - Humans

KW - Hypoglycemic Agents

KW - Insulin

KW - Male

KW - Metformin

KW - Middle Aged

KW - Natriuretic Peptide, Brain

KW - Peptide Fragments

KW - Proinsulin

KW - Prospective Studies

KW - Statistics, Nonparametric

KW - Thiazolidinediones

KW - Comparative Study

KW - Journal Article

KW - Randomized Controlled Trial

KW - Research Support, Non-U.S. Gov't

U2 - 10.1111/j.1365-2796.2006.01665.x

DO - 10.1111/j.1365-2796.2006.01665.x

M3 - Article

C2 - 16882276

SN - 1365-2796

VL - 260

SP - 125

EP - 133

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

IS - 2

ER -

Glycemic and non-glycemic effects of pioglitazone in triple oral therapy in patients with type 2 diabetes mellitus

Abstract

Bibliographical note

Subject classification (UKÄ)

Free keywords

UN SDGs

Access to Document

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Research output

Assessment and Treatment of Impaired Insulin- Secretion and Action in Type 2 Diabetes

Cite this