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

Research output: Contribution to journalArticle

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.

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Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems
  • Medicinal Chemistry
  • Endocrinology and Diabetes

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
Original languageEnglish
Pages (from-to)125-133
Number of pages9
JournalJournal of Internal Medicine
Volume260
Issue number2
Publication statusPublished - 2006 Aug
Publication categoryResearch
Peer-reviewedYes

Bibliographic 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)

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