title: [Prevention and treatment for development and progression of diabetic macroangiopathy with pioglitazone and metformin].
abstract: Prevention and treatment for diabetic macroangiopathy, causing the main etiology for mortality in patients with diabetes mellitus, is crucial target point, but is still controversial. Many clinical studies improving glycemic control by insulin and oral drugs were not demonstrating enough prevention for diabetic macroangiopathy to improve life prognosis. Insulin resistance is now considered to be major pathogenesis for diabetic macroangiopathy. The agents that improve insulin resistance, such as metformin and pioglitazone, have multiple effects to improve glucose and lipid metabolism by increasing sensitivity for insulin without increasing insulin secretion and exert anti-atherogenic properties resulting in preventing development of atherosclerosis. Some clinical studies such as UKPDS 34 and PROactive demonstrated preventive effects of these agents for diabetic macroangiopathy.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Juntendo University School of Medicine.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mokuno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daita
mesh_terms: D052242:Adiponectin; D001161:Arteriosclerosis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D016207:Cytokines; D003925:Diabetic Angiopathies / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D018450:Disease Progression; D019317:Evidence-Based Medicine; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008264:Macrophages; D008687:Metformin / Q000627:therapeutic use*; D047495:PPAR gamma; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*
chemical_list: D052242:Adiponectin; D016207:Cytokines; D007004:Hypoglycemic Agents; D047495:PPAR gamma; D045162:Thiazolidinediones; D008687:Metformin; D000077205:Pioglitazone