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 Comparison of Lipid and Glycemic Effects of Pioglitazone and Rosiglitazone in Patients With Type 2 Diabetes and Dyslipidemia
OBJECTIVE Published reports suggest that pioglitazone and rosiglitazone have different effects on lipids in patients with type 2 diabetes . However , these previous studies were either retrospective chart review s or clinical trials not rigorously controlled for concomitant glucose- and lipid-lowering therapies . This study examines the lipid and glycemic effects of pioglitazone and rosiglitazone . RESEARCH DESIGN AND METHODS We enrolled subjects with a diagnosis of type 2 diabetes ( treated with diet alone or oral monotherapy ) and dyslipidemia ( not treated with any lipid-lowering agents ) . After a 4-week placebo washout period , subjects r and omly assigned to the pioglitazone arm ( n = 400 ) were treated with 30 mg once daily for 12 weeks followed by 45 mg once daily for an additional 12 weeks , whereas subjects r and omly assigned to rosiglitazone  ( n = 402 ) were treated with 4 mg once daily followed by 4 mg twice daily for the same intervals . RESULTS Triglyceride levels were reduced by 51.9 + /- 7.8 mg/dl with pioglitazone , but were increased by 13.1 + /- 7.8 mg/dl with rosiglitazone ( P < 0.001 between treatments ) . Additionally , the increase in HDL cholesterol was greater ( 5.2 + /- 0.5 vs. 2.4 + /- 0.5 mg/dl ; P < 0.001 ) and the increase in LDL cholesterol was less ( 12.3 + /- 1.6 vs. 21.3 + /- 1.6 mg/dl ; P < 0.001 ) for pioglitazone compared with rosiglitazone , respectively . LDL particle concentration was reduced with pioglitazone and increased with rosiglitazone ( P < 0.001 ) . LDL particle size increased more with pioglitazone ( P = 0.005 ) . CONCLUSIONS Pioglitazone and rosiglitazone have significantly different effects on plasma lipids independent of glycemic control or concomitant lipid-lowering or other antihyperglycemic therapy . Pioglitazone compared with rosiglitazone is associated with significant improvements in triglycerides , HDL cholesterol , LDL particle concentration , and LDL particle size
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 .