title: Pioglitazone may accelerate disease course of slowly progressive type 1 diabetes.
abstract: BACKGROUND
  It has been reported that intervention with insulin in slowly progressive type 1 diabetic (SPIDDM) patients delays the progression to an insulin-dependent state compared to that with sulfonylureas. However, the rate of progression to SPIDDM with the use of insulin-sensitizing agents is unknown. The aim of this study was to determine the effect of insulin-sensitizing agents on SPIDDM patients.
  
  
  METHODS
  The enrolled SPIDDM patients were randomly allocated to a pioglitazone or metformin group. When the haemoglobin A1C level was more than 8% on two consecutive occasions, the case was considered to reach the end point.
  
  
  RESULTS
  By 4 years post-intervention, all patients had reached the end point in the pioglitazone group, whereas only 20% of patients had reached the end point in the metformin group (p<0.05).
  
  
  CONCLUSIONS
  Pioglitazone may accelerate the disease course of SPIDDM.
authors: Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. asmd@sc.itc.keio.ac.jp
authors: Akira
authors: A
authors: Shimada
authors: Toshikatsu
authors: T
authors: Shigihara
authors: Yoshiaki
authors: Y
authors: Okubo
authors: Takeshi
authors: T
authors: Katsuki
authors: Yoshifumi
authors: Y
authors: Yamada
authors: Yoichi
authors: Y
authors: Oikawa
mesh_terms: D000328:Adult; D017668:Age of Onset; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000009:adverse effects*
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin; D000077205:Pioglitazone; D045162:Thiazolidinediones