title: Clinical effect of combination therapy of pioglitazone and an alpha-glucosidase inhibitor.
abstract: This study evaluated the efficacy of adding pioglitazone 30 mg to the therapy of patients with type 2 diabetes mellitus whose glycaemic control was poor on an alpha-glucosidase inhibitor (alpha-GI) alone or in combination with a sulphonylurea (SU). The patients (n = 20) had a HbA(1c) level between 7.0 and 12.0% and the fasting plasma glucose was 7.8 mmol/l or higher. They were treated with 30 mg pioglitazone once daily for 16 weeks. The decrease in HbA(1c) at week 16 of treatment was 0.8% (7.8% at baseline dropping to 7.1% at week 16; p < or = 0.01). An increase in leptin was observed 4 weeks after starting the post-study period (p < or = 0.05). Tumour necrosis factor-alpha (TNF-alpha) and body fat percentage did not show any significant alterations. Correlations between the decrease in HbA1c at week 16 and characteristic variables of patients were examined. A correlation with leptin (p = -0.5632, p < or = 0.05) levels was found. Five patients experienced adverse drug reactions, such as oedema, hypoglycaemia and increased creatine phosphokinase (CK), all of which were mild in severity. The addition of pioglitazone in diabetics whose glycaemic control was poor on a alpha-GI alone or with a alpha-GI and SU combination resulted in a significant decrease in HbA1c, and the treatment was well-tolerated. Our findings also suggest that leptin levels could be useful for assessing responders to pioglitazone.
authors.affiliation: Internal Medicine Diabetes Center, Ohta Nishinouchi Hospital, 2-5-20 Nishinouchi Kooriyama-shi Fukushima-ken, 963-8558, Japan. h-seino@mva.biglobe.ne.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Seino
authors.forename: Hiyoshi
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Asako
authors.initials: A
authors.lastname: Misaki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Sakata
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kitagawa
authors.forename: Toshirou
authors.initials: T
authors.lastname: Yamazaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Abe
mesh_terms: D001786:Blood Glucose; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D020738:Leptin / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D013453:Sulfonylurea Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis
chemical_list: D001786:Blood Glucose; D004791:Enzyme Inhibitors; D006442:Glycated Hemoglobin; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D020738:Leptin; D000077205:Pioglitazone; D013453:Sulfonylurea Compounds; D045162:Thiazolidinediones; D014409:Tumor Necrosis Factor-alpha