Sustained effects of pioglitazone vs. glibenclamide on insulin sensitivity, glycaemic control, and lipid profiles in patients with Type 2 diabetes

Tan, Meng H.; Johns, Don; Strand, Jorma; Halse, Johan; Madsbad, Sten; Eriksson, Jan W.; Clausen, Jens; Konkoy, Christopher S.; Herz, Matthias

doi:10.1111/j.1464-5491.2004.01258.x

Cited by 62 publications

(41 citation statements)

References 36 publications

(40 reference statements)

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“…The effect of pioglitazone (when used as monotherapy) on HOMA-%S and QUICKI in patients with type 2 diabetes has been previously reported (13)(14)(15). Its effect compared with placebo on CISI in patients with type 2 diabetes has also been reported (11).…”

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confidence: 91%

Comparison of Effect of Pioglitazone With Metformin or Sulfonylurea (Monotherapy and Combination Therapy) on Postload Glycemia and Composite Insulin Sensitivity Index During an Oral Glucose Tolerance Test in Patients With Type 2 Diabetes

et al. 2005

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OBJECTIVE -Pioglitazone, metformin, and gliclazide lower HbA 1c and fasting plasma glucose in patients with type 2 diabetes. We compared the effects of these three drugs, used as monotherapy and in combination, on postload glycemia and composite insulin sensitivity index (CISI) in these patients.RESEARCH DESIGN AND METHODS -Postload glycemia and CISI were analyzed for 940 patients who had oral glucose tolerance tests (OGTTs) in four multicenter, randomized, double-blind, double-dummy, parallel group clinical trials (pioglitazone versus metformin, pioglitazone versus gliclazide, pioglitazone plus sulfonylurea versus metformin plus sulfonylurea, and pioglitazone plus metformin versus gliclazide plus metformin). Plasma glucose and insulin were determined during the 3-h OGTT performed at baseline and after 1 year of therapy. Incremental area under the curve for glucose was the surrogate for postload glycemia. CISI was calculated using the formula {10,000/͌ of [(fasting glucose ϫ fasting insulin) ϫ (mean glucose ϫ mean insulin)]} during the OGTT.RESULTS -In monotherapy, pioglitazone reduced postload glycemia and enhanced CISI more than metformin and gliclazide. In combination therapy, pioglitazone plus sulfonylurea reduced postload glycemia and increased CISI more than metformin plus sulfonylurea. Pioglitazone plus metformin also decreased postload glycemia and increased CISI more than gliclazide plus metformin.CONCLUSIONS -Pioglitazone improves postload glycemia and CISI more than metformin or gliclazide when used as monotherapy or in combination therapy in patients with type 2 diabetes. Diabetes Care 28:266 -272, 2005

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confidence: 91%

Comparison of Effect of Pioglitazone With Metformin or Sulfonylurea (Monotherapy and Combination Therapy) on Postload Glycemia and Composite Insulin Sensitivity Index During an Oral Glucose Tolerance Test in Patients With Type 2 Diabetes

et al. 2005

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“…Results of comparator studies suggest that even if pioglitazone effects on HbA 1c require a longer period to be evident, pioglitazone allows a more sustained glycemic control and improvement in insulin sensitivity than glibenclamide. 23 Results from clinical studies clearly show a substantial superiority of pioglitazone in ameliorating lipids in diabetes patients, compared with other molecules. Pioglitazone significantly increases HDL-C while both glimepiride and glibenclamide do not affect this parameter.…”

Section: Efficacy Studies With Pioglitazonementioning

confidence: 99%

Risk management in the treatment of type 2 diabetes with pioglitazone

Derosa

Salvadeo

2009

DMSO

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“…Similarly, pioglitazone proved significantly superior to the DPP-IV inhibitor sitagliptin in reducing HbA1c levels in drug-naïve people with type 2 diabetes [15] as reported in the ADA/EASD consensus expert statement [7]. Furthermore, in drug-naïve people with type 2 diabetes , at a 2-year follow-up, pioglitazone treated subjects maintained acceptable metabolic control (HbA1c < 8%; 64 mmol/mol) in a significantly larger proportion than did gliclazide-treated subjects [14,16]. Similar results were achieved when the two drugs were used in addition to metformin [17].…”

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Do thiazolidinediones still have a role in treatment of type 2 diabetes mellitus?

Consoli

Formoso

2013

Diabetes Obesity Metabolism

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Thiazolidinediones have been introduced in the treatment of type 2 diabetes mellitus (T2DM) since the late 1990s. Although troglitazone was withdrawn from the market a few years later due to liver toxicity, both rosiglitazone and pioglitazone gained widespread use for T2DM treatment. In 2010, however, due to increased risk of cardiovascular events associated with its use, the European Medicines Agency recommended suspension of rosiglitazone use and the Food and Drug Administration severely restricted its use. Thus pioglitazone is the only thiazolidinedione still significantly employed for treating T2DM and it is the only molecule of this class still listed in the American Diabetes Association-European Association for the Study of Diabetes 2012 Position Statement. However, as for the other thiazolidinediones, use of pioglitazone is itself limited by several side effects, some of them potentially dangerous. This, together with the development of novel therapeutic strategies approved in the last couple of years, has made it questionable whether or not thiazolidinediones (namely pioglitazone) should still be used in the treatment of T2DM. This article will attempt to formulate an answer to this question by critically reviewing the available data on the numerous advantages and the potentially worrying shortcomings of pioglitazone treatment in T2DM. Keywords: PPAR-gamma agonist, thiazolidinediones, type 2 diabetes Date submitted 7 September 2012; date of first decision 23 November 2012; date of final acceptance 15 March 2013 IntroductionThiazolidinediones are selective ligands of the nuclear transcription factor peroxisome-proliferator-activated receptor γ (PPARγ ). These are a subfamily of the 48-member nuclear-receptor superfamily which, once activated by ligand binding, bind to DNA in complex with the retinoid X receptor (RXR), thus modulating the transcription of a number of specific genes [1]. Since the late 1990s, thiazolidinediones have been introduced in the treatment of type 2 diabetes mellitus (T2DM), mostly as second-line agents, in combination with metformin. Three thiazolidinedione molecules have been used in clinical practice over the last 15 years: troglitazone, rosiglitazone and pioglitazone. Troglitazone, the first thiazolidinedione approved for clinical use in 1997, was withdrawn from the market 3 years later, after reports of a few individual cases of liver injury and failure associated with use of the drug [2]. On the other hand both rosiglitazone and pioglitazone gained widespread employment for T2DM treatment in the early years of the last decade. Then, mostly prompted by the results of a meta-analysis showing association of its use with increased cardiovascular events [3], rosiglitazone underwent very close scrutiny by both Food and Drug Administration (FDA) andCorrespondence to: Prof. Agostino Consoli, MD, Department of Medicine and Aging Sciences, Edificio CeSi, Room 271, University of Chieti, via dei Vestini, 1, 66100 Chieti, Italy. E-mail: consoli@unich.it European Medicines Agency (EMA) [4]...

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Sustained effects of pioglitazone vs. glibenclamide on insulin sensitivity, glycaemic control, and lipid profiles in patients with Type 2 diabetes

Cited by 62 publications

References 36 publications

Comparison of Effect of Pioglitazone With Metformin or Sulfonylurea (Monotherapy and Combination Therapy) on Postload Glycemia and Composite Insulin Sensitivity Index During an Oral Glucose Tolerance Test in Patients With Type 2 Diabetes

Comparison of Effect of Pioglitazone With Metformin or Sulfonylurea (Monotherapy and Combination Therapy) on Postload Glycemia and Composite Insulin Sensitivity Index During an Oral Glucose Tolerance Test in Patients With Type 2 Diabetes

Risk management in the treatment of type 2 diabetes with pioglitazone

Do thiazolidinediones still have a role in treatment of type 2 diabetes mellitus?

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