Further , in a cohort study of patients with type 2 diabetes , pioglitazone therapy was associated with a statistically significant decrease in the risk of all-cause mortality .
Despite these beneficial effects , the meta- analysis showed that pioglitazone therapy had higher risks of heart failure , bone fractures , edema and weight gain .
The low-dose pioglitazone therapy may show the same degree of improvements in glucose and lipid metabolism , fatty liver , insulin resistance , and adiponectin as the st and ard- and high-dose pioglitazone therapy .
Furthermore , the low-dose pioglitazone therapy may also show less adverse effects on weight gain , edema and heart failure as compared with the st and ard- and high-dose pioglitazone therapy
Pioglitazone is one of thiazolidinedione derivatives , which stimulates nuclear peroxisome proliferator-activated receptor gamma and improves glucose and lipid metabolism and insulin sensitivity .
A recent systematic review and meta- analysis showed that pioglitazone therapy was associated with a lower risk of major adverse cardiovascular events in patients with pre-diabetes and diabetes .
A long-term comparison of pioglitazone and gliclazide in patients with Type 2 diabetes mellitus: a randomized, double-blind, parallel-group comparison trial.
AIMS This study compared the effects of pioglitazone and gliclazide on metabolic control in drug-naive patients with Type 2 diabetes mellitus . METHODS A total of 1270 patients with Type 2 diabetes were r and omized in a parallel-group , double-dummy , double-blind study . Patients with poorly controlled Type 2 diabetes ( HbA1c 7.5 - 11 % ) , despite dietary advice , received either pioglitazone up to 45 mg once daily or gliclazide up to 160 mg two times daily . Primary efficacy endpoint was change in HbA1c from baseline to the end of the study . Secondary efficacy endpoints included change in fasting plasma glucose , fasting plasma insulin and plasma lipids . At selected centres , oral glucose tolerance tests were performed and C-peptide and pro-insulin levels were measured . RESULTS Mean HbA1c values decreased by the same amount in the two treatment groups from baseline to week 52 [ pioglitazone : -1.4 % ; gliclazide : -1.4 % ; ( 90 % CI : -0.18 to 0.02 ) ] . A significantly greater mean reduction in fasting plasma glucose was observed in the pioglitazone group ( 2.4 mmol/l ) than in the gliclazide group [ 2.0 mmol/l ; treatment difference -0.4 mmol/l in favour of pioglitazone ; P = 0.002 ; ( 95 % CI : -0.7 to -0.1 ) ] . Improvements in high-density lipoprotein cholesterol ( HDL-C ) and total cholesterol/HDL-C were greater with pioglitazone than with gliclazide ( P < 0.001 ) . The frequencies of adverse events were comparable between the two treatment groups , but more hypoglycaemic events were reported for gliclazide , whereas twice as many patients reported oedema with pioglitazone than with gliclazide . CONCLUSIONS Pioglitazone monotherapy was equivalent to gliclazide in reducing HbA1c , with specific differences between treatments in terms of mechanism of action , plasma lipids and adverse events
Further , in a cohort study of patients with type 2 diabetes , pioglitazone therapy was associated with a statistically significant decrease in the risk of all-cause mortality .
Despite these beneficial effects , the meta- analysis showed that pioglitazone therapy had higher risks of heart failure , bone fractures , edema and weight gain .
The low-dose pioglitazone therapy may show the same degree of improvements in glucose and lipid metabolism , fatty liver , insulin resistance , and adiponectin as the st and ard- and high-dose pioglitazone therapy .
Furthermore , the low-dose pioglitazone therapy may also show less adverse effects on weight gain , edema and heart failure as compared with the st and ard- and high-dose pioglitazone therapy
Pioglitazone is one of thiazolidinedione derivatives , which stimulates nuclear peroxisome proliferator-activated receptor gamma and improves glucose and lipid metabolism and insulin sensitivity .
A recent systematic review and meta- analysis showed that pioglitazone therapy was associated with a lower risk of major adverse cardiovascular events in patients with pre-diabetes and diabetes .