Effects of pioglitazone on metabolic control and blood pressure: a randomised study in patients with type 2 diabetes mellitus.
OBJECTIVE
This Swiss multicentre study examined the efficacy and safety of oral pioglitazone in patients with type 2 diabetes.


METHODS
Patients were randomised to pioglitazone at once-daily doses of 30 mg for 20 weeks (n = 76), 30 mg for 12 weeks followed by 45 mg for 8 weeks (n = 74), or 45 mg for 20 weeks (n = 84); 94.9% of patients completed 12 weeks and 88.9% completed all 20 weeks. Almost all (96.6%) patients received pioglitazone in combination with other anti-diabetic treatments.


RESULTS
Mean HbA(1c) at baseline was 8.8 +/- 1.2%, and changes to endpoint were -1.1 +/- 1.1%, -1.1 +/- 1.4% and -0.9 +/- 1.6%, respectively for the three dose groups ( p < 0.001 for each group). Triglyceride concentrations decreased in each group and the overall mean change during the study was -0.58 mmol/l (p < 0.001 versus baseline). HDL-cholesterol increased, with an overall mean change of 0.10 mmol/l (p < 0.001 versus baseline). Blood pressure decreased from baseline, particularly for hypertensive patients with mean changes: systolic -10 mmHg, p < 0.001, diastolic -8 mmHg, p < 0.001 versus baseline. Serum alanine aminotransferase and gamma-glutamyl transferase concentrations were significantly (p < 0.001 for each) reduced during the study.


CONCLUSIONS
The study demonstrates the efficacy of pioglitazone 30 mg/day and 45 mg/day in the treatment of type 2 diabetes, with an improved lipid profile and decreased blood pressure in addition to improved glycaemic control.
Gerber
Pietro
P
Clinica al Parco, Lugano, Switzerland. pietrogerber@diabetelugano.com
Lübben
Georg
G
Heusler
Sabine
S
Dodo
Ayako
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D008055:Lipids; D045162:Thiazolidinediones; D000077205:Pioglitazone