Pioglitazone in Type 2 Diabetes Poorly Controlled With a-Glucosidase Inhibitors, Alone or in Combination With Sulfonylureas

Hayashi Y, Miyachi N, Takeuchi T, et al 

Twenty patients with type 2 diabetes poorly controlled with a-glucosidase inhibitors, alone or in combination with a sulfonylurea, were enrolled in a 16-week, open-label study to receive 30 mg pioglitazone, orally, once a day in addition to their current medications.  

Statistically significant reductions from baseline A1C, fasting plasma glucose, and postprandial plasma glucose levels were seen after 16 weeks of pioglitazone therapy. In addition, pioglitazone therapy was associated with significantly increased HDL-C levels and reduced free-fatty acid levels; reductions in TG and LDL-C levels were also observed, but these did not reach statistical significance.  Adverse reactions included edema, hypoglycemia-like reactions, microscopic hematuria, decreased platelet counts, and increased levels of lactate dehydrogenase, creatinine phosphokinase, and blood urea nitrogen. 

On average, patients experienced a gradual, but significant weight gain, although percent body fat remained relatively constant throughout the study. 
No significant changes in tumor necrosis factor-a were detected, but statistically significant increases in leptin were seen after 16 weeks and continued throughout the 4-week post-treatment follow-up. Further review of potentially influential demographic variables revealed that patients with high baseline postprandial 2-hour plasma glucose levels, high body-fat percentages, or high leptin levels had greater reductions in A1C with pioglitazone. 

Data from this study indicate that pioglitazone is an effective antidiabetic agent for patients with type 2 diabetes poorly controlled with glucosidase inhibitors, alone or in combination with sulfonylureas.

 

Hayashi Y, Miyachi N, Takeuchi T, et al. Clinical evaluation of pioglitazone in patients with type 2 diabetes using a-glucosidase inhibitor and examination of its efficacy profile. Diabetes Obes Metab. 2003;5:58-65.
The above summary is adapted from the cited reference. 

Last Modified: 2/19/2013