Prevention of weight gain in adult patients with type 2 diabetes treated with pioglitazone

Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. 

Pioglitazone, a thiazolidinedione (TZD) commonly used to treat type 2 diabetes, is associated with weight gain. Our study was designed to examine the effectiveness of three lifestyle-treatment programs of varying intensity on prevention of pioglitazone-induced weight gain and to measure the composition of the change in body weight. Thirty-nine adult overweight and obese subjects with type 2 diabetes mellitus were all treated with pioglitazone and prospectively randomized to one of three lifestyle-treatment programs with increasing level of intensity for 24 weeks. Body composition was measured by dual-energy X-ray absorptiometry (DXA), computed tomography, and multifrequency bioimpedance analysis both before and after therapy. Subjects demonstrated a "dose-response" effectiveness to three levels of lifestyle intervention to mitigate pioglitazone-induced weight gain. Mean (s.d.) weight change (kg) for the usual, standard, and intensive lifestyle groups were 4.9 &plusmn; 4.9 (P= 0.005), 1.8 &plusmn; 3.4 (P=0.02), and -0.2 &plusmn; 4.4 (NS) respectively. Total body fat increased 2.6 &plusmn; 3.4 kg (P=0.04) for the usual group and decreased for the intensive group -0.4 &plusmn; 3.5 (NS). Change in abdominal subcutaneous and visceral adipose tissue (VAT) did not differ between groups, although ratio of visceral/subcutaneous fat decreased for the standard and intensive groups (NS). Both usual (P<0.05) and standard care (NS) groups gained total body water. This is the first prospective, randomized study that demonstrates the beneficial effect of participation in a comprehensive lifestyle-weight-management program on lessening of weight gain associated with pioglitazone. 

PMID: 19180065 [PubMed - as supplied by publisher] 


Kushner RF, Sujak M. Prevention of weight gain in adult patients with type 2 diabetes treated with pioglitazone. Ophthalmology. 2009 Jan 29. [Epub ahead of print]. 

Last Modified: 2/22/2013