title: Pioglitazone as adjunctive therapy in adolescents with type 1 diabetes.
abstract: OBJECTIVE
  To determine whether the addition of the thiazoladinedione, pioglitazone, to standard therapy improves metabolic control in adolescents with type 1 diabetes (T1D) and clinical evidence of insulin resistance.
  
  
  METHODS
  Randomized, placebo-controlled 6-month 2-site trial of pioglitazone therapy in 35 adolescents with T1D, high insulin requirements (>0.9 U/kg/d), and suboptimal metabolic control (A1c 7.5%-11%), with the primary outcome of change in A1c. Secondary outcomes include change in insulin dose, body mass index (BMI), lipids, and waist and hip circumference.
  
  
  RESULTS
  Metabolic control (A1c) was improved at 6 months in all subjects (P = .02). There was no significant difference between the pioglitazone and placebo treatment groups at 6 months in either change in A1c (-0.4% +/- 0.9% and -0.5% +/- 1.2%, respectively) or insulin dose. BMI SDS increased by 0.3 +/- 0.3 (kg/m(2)) in the pioglitazone group and remained unchanged in the placebo group (P = .01). There was no significant difference in change in any lipid parameters between the pioglitazone and placebo groups at 6 months.
  
  
  CONCLUSIONS
  Adjunctive pioglitazone therapy was not effective in improving glycemic control in adolescents with T1D. Pioglitazone was associated with increased BMI.
authors.affiliation: Division of Endocrinology, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Vera
authors.initials: V
authors.lastname: Zdravkovic
authors.forename: Jill K
authors.initials: JK
authors.lastname: Hamilton
authors.forename: Denis
authors.initials: D
authors.lastname: Daneman
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Cummings
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000187:drug effects; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000378:metabolism*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007333:Insulin Resistance; D008297:Male; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000008:administration & dosage*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone