title: Effects of pioglitazone on blood glucose and inflammatory markers of diabetic kidney transplant patients: a randomized controlled trial.
abstract: BACKGROUND
  The aim of this study was to assess the effects of pioglitazone on blood glucose control and inflammatory biomarkers in diabetic patients receiving insulin after kidney transplantation.
  
  
  METHODS
  In a randomized placebo-controlled trial, 62 diabetic kidney transplant patients were followed for 4 months after randomly assigned to placebo and pioglitazone (30 mg/d) groups. All of the patients continued their insulin therapy irrespective of the group that they were assigned to, in order to evaluate the effects of addition of pioglitazone on blood glucose and inflammation biomarkers including serum C-reactive protein, high-sensitivity C-reactive protein, and interleukin-18 levels, as well as erythrocyte sedimentation rate.
  
  
  RESULTS
  At baseline, there were no significant differences in laboratory studies between the two groups. After 4 months of intervention, along with significant improvement in hemoglobin A1c in the pioglitazone group, daily insulin requirements also decreased and lipid profile improved significantly. In addition, erythrocyte sedimentation rate, C-reactive protein, and high-sensitivity C-reactive protein values were significantly lower in the pioglitazone group (P = .03, P < .001, and P = .01). Interleukin-18 levels were not significantly different at the end of the study between the two groups, but it had a decreasing trend in the pioglitazone group (P = .002).
  
  
  CONCLUSIONS
  Pioglitazone complementing insulin in diabetic kidney transplant patients not only improved glycemic control, evidenced by hemoglobin A1c, and reduced daily insulin requirement, but also decreased inflammatory markers which may have an impact on overall cardiovascular events and mortalities beyond glycemic control.
authors.forename: Ali
authors.initials: A
authors.lastname: Kharazmkia
authors.affiliation: Department of Nephrology and Kidney Transplantation, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Pedram.ahmadpoor@gmail.com.
authors.forename: Pedram
authors.initials: P
authors.lastname: Ahmadpoor
authors.forename: Shadi
authors.initials: S
authors.lastname: Ziaei
authors.forename: Jamshid
authors.initials: J
authors.lastname: Salamzadeh
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Pour-Reza-Gholi
authors.forename: Alireza
authors.initials: A
authors.lastname: Khoshdel
authors.forename: Shiva
authors.initials: S
authors.lastname: Samavat
authors.forename: Fariba
authors.initials: F
authors.lastname: Samadian
authors.forename: Mohsen
authors.initials: M
authors.lastname: Nafar
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000187:drug effects*; D001799:Blood Sedimentation / Q000187:drug effects; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D020382:Interleukin-18 / Q000097:blood; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D020382:Interleukin-18; D045162:Thiazolidinediones; D002097:C-Reactive Protein; D000077205:Pioglitazone