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Glycemic and non-glycemic effects of pioglitazone in triple oral therapy in patients with type 2 diabetes mellitus

Författare:
Publiceringsår: 2006
Språk: Engelska
Sidor: 125-133
Publikation/Tidskrift/Serie: Journal of Internal Medicine
Volym: 260
Nummer: Aug
Dokumenttyp: Artikel
Förlag: Blackwell

Sammanfattning

Objectives. To examine pioglitazone as add-on to
metformin and insulin secretagogues in patients
with type 2 diabetes and inadequate glycaemic
control and its effect on glycaemic control, surrogate
measures of insulin sensitivity (adiponectin) and
b-cell function (proinsulin/insulin) and fluid
retention.
Design and setting. Prospective open-label study of
54 patients with type 2 diabetes and HbA1c ‡6.5%
admitted to outpatient unit at Malmo¨ University
Hospital. The patients received 30–45 mg
pioglitazone daily during 26 weeks in addition to
their existing antidiabetic medication. After
26 weeks, one-third of patients were followed for
3 months without pioglitazone.
Results. HbA1c decreased (7.8 ± 0.9–6.3 ± 0.9%,
P < 0.001) with 61% of patients achieving levels
<6.5%. However, in the group followed for another
3 months HbA1c increased (6.1 ± 0.73–7.1 ± 0.9,
n ¼ 18, P < 0.001) after pioglitazone withdrawal.
Adiponectin increased (6.1 ± 2.8–13.2 ±
5.8 lg mL)1, P < 0.001) and the proinsulin to
insulin ratio decreased (0.89 ± 0.66–0.66 ± 0.53,
P < 0.001). Nt-proBNP increased from 487.3 ±
252.2 to 657.8 ± 392.1 pmol L)1 (P < 0.001).
Conclusions. Pioglitazone is effective in achieving
glycaemic targets and reducing risk factors involved
in atherosclerosis and improving b-cell function
when used as part of triple oral therapy in patients
with type 2 diabetes and secondary drug failure.
Nt-proBNP increase with concomitant decrease in
haemoglobin suggests a subclinical sign of fluid
retention.

Disputation

Nyckelord

  • Medicine and Health Sciences
  • thiazolidinediones
  • oral therapy
  • adiponectin
  • NT-proBNP
  • type 2

Övriga

Published
Yes

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