Effects of Pioglitazone Hydrochloride on Japanese Patients with Type 2 Diabetes Mellitus

Teramoto, Tamio; Yamada, Nobuhiro; Shirai, Kohji; Saitō, Yasushi

doi:10.5551/jat.14.86

Cited by 13 publications

(6 citation statements)

References 43 publications

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“…Two studies have described the change of insulin sensitivity after PIO treatment in less obese (but not real lean) diabetes patients. One study found that PIO significantly decreased HOMA-IR [ 16 ], but in another study no significant decrease of insulin resistance was found in non-obese patients even though blood glucose was effectively controlled by PIO [ 17 ]. It may be that the method used for evaluating insulin sensitivity led to the different findings between the two Japanese studies and our study.…”

Section: Discussionmentioning

confidence: 99%

Pioglitazone Improved Insulin Sensitivity and First Phase Insulin Secretion Among Obese and Lean People with Diabetes: A Multicenter Clamp Study

et al. 2018

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IntroductionTo investigate the effects of pioglitazone (PIO) on insulin resistance and first phase insulin secretion among obese and lean Chinese people with type 2 diabetes mellitus (T2DM).MethodsSixty-eight drug-naïve patients with T2DM were treated with PIO for 16 weeks. Before and after the treatment, insulin sensitivity was evaluated by the euglycemic hyperinsulinemic clamp test. Plasma insulin levels at 0, 3, 5, 7, and 10 min during intravenous glucose tolerance test were determined to calculate the first phase insulin secretion and pancreatic β-cell function. Circulating adiponectin levels were quantified.ResultsIn both the lean and the obese patients with T2DM, the reduction of HbA1c following the PIO treatment was more than 1% (P < 0.001) and glucose infusion rate, acute insulin response, glucose disposal index, and β-cell glucose sensitivity increased significantly (P < 0.001). A multiple linear regression analysis showed that the improvements of first phase insulin secretion and insulin sensitivity were independently associated with the changes of HbA1c, but the change of first phase insulin secretion exhibited a higher correlation coefficient (R2 = 0.20, P = 0.001) than the change of insulin sensitivity did (R2 = 0.07, P = 0.040). The PIO treatment led to a significant increase in adiponectin levels only in the obese group (P < 0.05).ConclusionA 16-week treatment of PIO significantly increased insulin sensitivity and β-cell function in the lean group as well as in the obese group among Chinese T2DM patients, demonstrating that both lean and obese diabetic adults would profit from PIO.Trial registrationThe ChiCTR registry number is ChiCTR-OPC-17011571.FundingTakeda Pharmaceutical Co. Ltd. and Pfizer Pharmaceutical Co. Ltd.

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Section: Discussionmentioning

confidence: 99%

Pioglitazone Improved Insulin Sensitivity and First Phase Insulin Secretion Among Obese and Lean People with Diabetes: A Multicenter Clamp Study

et al. 2018

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“…[55][56][57] Pioglitazone increased HDL-C more so than metformin, 6,9,[12][13][14][15][16]19 rosiglitazone, [55][56][57] and sulfonylureas in pooled analyses. 12,13,50,[58][59][60] For these comparisons, pooled between-group differences ranged from + 0.5 mg per dL to + 4.3 mg per dL. Changes in HDL-C were similar in comparisons of metformin with sulfonylureas or rosiglitazone.…”

Section: Comparative Effects Of Monotherapy Interventions On A1cmentioning

confidence: 96%

AHRQ’s Comparative Effectiveness Research on Oral Medications for Type 2 Diabetes: A Summary of the Key Findings

Bennett¹,

Balfe²,

Faysal³

2012

JMCP

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Type 2 diabetes mellitus is a major public health burden. Since the 2007 AHRQ systematic review of oral medications for type 2 diabetes, the FDA has approved several new drug classes. Therefore, in 2011, the original systematic review was updated with comparisons including the newer oral diabetes medications. The updated report expands beyond the scope of the original 2007 review by including comparisons of 2-drug combinations and the addition of more head-to-head comparisons, as well as additional adverse outcomes. A high strength of evidence showed that most medications were similarly efficacious at lowering hemoglobin A1c by about 1 absolute percentage point compared with baseline values. The addition of most oral medications to initial monotherapy further improved glycemiccontrol by lowering A1c by another 1 percentage point. The only exception was the DPP-4 inhibitor class, which did not lower A1c to the same extent as metformin when used as monotherapy. Overall, metformin was found to have a more favorable effect on body weight when compared with other medications. Two-drug combinations compared with each other demonstrated similar reductions in A1c levels. Metformin decreased low-density lipoprotein cholesterol (LDL-C) relative to pioglitazone, sulfonylureas,and DPP-4 inhibitors. Sulfonylureas had a 4-fold higher risk of mild-to-moderate hypoglycemia compared with metformin alone, and, in combination with metformin, had more than a 5-fold increased risk compared with metformin plus a thiazolidinedione. Thiazolidinediones had an increased risk of congestive heart failure relative to sulfonylureas, and an increased risk for bone fractures relative to metformin. Diarrhea occurred more often for metformin users compared with thiazolidinedione users. Although the long-term risks and benefits of diabetes medications remain unclear, the evidence supports the use of metformin as a first-line agent.

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“…[44][45][46][47][48] Clinical studies with pioglitazone have shown that this agent may reduce triglyceride levels, elevate HDL-C levels, and improve LDL particle size and susceptibility to oxidation. 49,50 In one clinical study, sitagliptin reduced total cholesterol, triglycerides, and non-HDL-C while increasing HDL-C. 51 Tight glycemic control with insulin may reduce triglyceride levels. 42 In one study, intensive insulin therapy for 4 weeks significantly reduced triglyceride levels (from 260 6 28 mg/dL to 133 6 14 mg/dL; P , 0.001) in individuals with uncontrolled type 2 diabetes on metformin or sulfonylurea monotherapy.…”

Section: Combined Management Of Hyperglycemia and Dyslipidemiamentioning

confidence: 98%

Reducing Cardiovascular Complications of Type 2 Diabetes by Targeting Multiple Risk Factors

Reasner¹

2008

Journal of Cardiovascular Pharmacology

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Insulin resistance syndrome is characterized by hyperglycemia, atherogenic dyslipidemia, hypertension, and abdominal obesity. Hyperglycemia is the major risk factor for microvascular complications in type 2 diabetes. However, 70% to 80% of patients with type 2 diabetes will die of macrovascular disease. Atherogenic dyslipidemia-characterized by elevated triglyceride levels, low high-density lipoprotein cholesterol (HDL-c) levels, and a preponderance of small, dense, low-density lipoprotein (LDL) particles-is the major cause of atherosclerosis in individuals with type 2 diabetes. Therefore, treatment of type 2 diabetes must address hyperglycemia to prevent microvascular disease (retinopathy, neuropathy, and nephropathy) and atherogenic dyslipidemia to prevent macrovascular complications. Emerging evidence indicates lipid and glucose homeostasis are interrelated via bile acid-activated nuclear hormone receptor signaling pathways. Agents that act on these pathways could simultaneously address hyperglycemia and dyslipidemia in patients with type 2 diabetes. Recent studies have shown that bile acid sequestrants, including cholestyramine, colestimide, and colesevelam HCl, significantly improve glycemic control and reduce LDL cholesterol levels in patients with type 2 diabetes. This paper will review the effects of bile acid sequestrants on both glucose and lipid metabolism in patients with type 2 diabetes.

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Effects of Pioglitazone Hydrochloride on Japanese Patients with Type 2 Diabetes Mellitus

Cited by 13 publications

References 43 publications

Pioglitazone Improved Insulin Sensitivity and First Phase Insulin Secretion Among Obese and Lean People with Diabetes: A Multicenter Clamp Study

Pioglitazone Improved Insulin Sensitivity and First Phase Insulin Secretion Among Obese and Lean People with Diabetes: A Multicenter Clamp Study

AHRQ’s Comparative Effectiveness Research on Oral Medications for Type 2 Diabetes: A Summary of the Key Findings

Reducing Cardiovascular Complications of Type 2 Diabetes by Targeting Multiple Risk Factors

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