Background: Insulin resistance is often associated with increased triglyceride (TG) and decreased HDL-cholesterol (HDL-C) concentrations and increased small LDL particles. The Atherogenic Index of Plasma (AIP), defined as log(TG/HDL-C), has recently been proposed as a marker of plasma atherogenicity because it is increased in people at higher risk for coronary heart disease and is inversely correlated with LDL particle size. We studied the effect of pioglitazone, a thiazolidinedione that reduces insulin resistance, on the AIP of patients with type 2 diabetes. Methods: The data for the analysis of AIP in this report were obtained from four randomized, double-blind, multicenter, parallel-group, placebo-controlled clinical trials. Pioglitazone was used as monotherapy in one study and in combination therapy in three studies.

Pioglitazone improved insulin resistance and glycemic control, as well as Tg and HDL-C - which suggests that pioglitazone may reduce cardiovascular risk for patients with type 2 diabetes.

PIO monotherapy and combination therapy with SU or MET enhanced insulin sensitivity as evaluated by HOMA-S and QUICKI. Both measures can detect changes in sensitivity for large numbers of subjects when the reference method hyperinsulinemic euglycemic clamp, or other complex methods are not feasible.

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Abstract:Initially discovered in 1921, insulin was fIrst made commercially available in 1923. Up until the early 1980s, all insulin preparations used medically were obtained by direct extraction from the pancreatic tissue of animals. In 1982, Hmnulin ® (recombinant hmnan insulin) became the fust recombinant therapeutic product to gain marketing approval. By the mid-1980s, efforts to develop insulin analogues displaying improved therapeutic properties were well underway. Insulin LISPRO (Hmnalog(R)) is such an analogue which has gained regulatory approval for general medical use. It is identical to hmnan insulin except that the Pro-Lys amino acid sequence at positions B28 and B29 of the native molecule are reversed.Insulin lispro has a more rapid onset of activity and a shorter duration of action when compared to regular hmnan insulin while maintaining equal glucose lowering ability. Insulin lispro provides better postprandial glucose control at a more convenient time relative to consmnption of a meal.