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

Dorkhan, M LU ; Magnusson, Martin LU ; Frid, A LU ; Grubb, A LU ; Groop, L LU and Jovinge, S LU (2006) In Journal of Internal Medicine 260(2). p.125-133
Abstract

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 beta-cell function (proinsulin/insulin) and fluid retention.

DESIGN AND SETTING: Prospective open-label study of 54 patients with type 2 diabetes and HbA1c>or=6.5% admitted to outpatient unit at Malmö 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%,... (More)

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 beta-cell function (proinsulin/insulin) and fluid retention.

DESIGN AND SETTING: Prospective open-label study of 54 patients with type 2 diabetes and HbA1c>or=6.5% admitted to outpatient unit at Malmö 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=18, P<0.001) after pioglitazone withdrawal. Adiponectin increased (6.1+/-2.8-13.2+/-5.8 microg 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 beta-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.

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keywords
Adiponectin, Administration, Oral, Aged, Biomarkers, Blood Glucose, Case-Control Studies, Cystatin C, Cystatins, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Female, Glyburide, Hemoglobin A, Glycosylated, Humans, Hypoglycemic Agents, Insulin, Male, Metformin, Middle Aged, Natriuretic Peptide, Brain, Peptide Fragments, Proinsulin, Prospective Studies, Statistics, Nonparametric, Thiazolidinediones, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
in
Journal of Internal Medicine
volume
260
issue
2
pages
9 pages
publisher
Wiley-Blackwell
external identifiers
  • wos:000239006800003
  • pmid:16882276
  • scopus:33745908261
  • pmid:16882276
ISSN
1365-2796
DOI
10.1111/j.1365-2796.2006.01665.x
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pediatrics/Urology/Gynecology/Endocrinology (013240400), Hematopoietic Stem Cell Laboratory (013022012), Division of Clinical Chemistry and Pharmacology (013250300), Diabetes and Endocrinology (013241530)
id
0657d37b-ce11-4165-af14-b7aea3d64874 (old id 160315)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16882276&dopt=Abstract
date added to LUP
2016-04-01 16:42:06
date last changed
2021-10-06 02:02:31
@article{0657d37b-ce11-4165-af14-b7aea3d64874,
  abstract     = {<p>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 beta-cell function (proinsulin/insulin) and fluid retention.</p><p>DESIGN AND SETTING: Prospective open-label study of 54 patients with type 2 diabetes and HbA1c&gt;or=6.5% admitted to outpatient unit at Malmö 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.</p><p>RESULTS: HbA1c decreased (7.8+/-0.9-6.3+/-0.9%, P&lt;0.001) with 61% of patients achieving levels&lt;6.5%. However, in the group followed for another 3 months HbA1c increased (6.1+/-0.73-7.1+/-0.9, n=18, P&lt;0.001) after pioglitazone withdrawal. Adiponectin increased (6.1+/-2.8-13.2+/-5.8 microg mL-1, P&lt;0.001) and the proinsulin to insulin ratio decreased (0.89+/-0.66-0.66+/-0.53, P&lt;0.001). Nt-proBNP increased from 487.3+/-252.2 to 657.8+/-392.1 pmol L-1 (P&lt;0.001).</p><p>CONCLUSIONS: Pioglitazone is effective in achieving glycaemic targets and reducing risk factors involved in atherosclerosis and improving beta-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.</p>},
  author       = {Dorkhan, M and Magnusson, Martin and Frid, A and Grubb, A and Groop, L and Jovinge, S},
  issn         = {1365-2796},
  language     = {eng},
  number       = {2},
  pages        = {125--133},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Internal Medicine},
  title        = {Glycemic and non-glycemic effects of pioglitazone in triple oral therapy in patients with type 2 diabetes mellitus},
  url          = {https://lup.lub.lu.se/search/files/4754661/625550.pdf},
  doi          = {10.1111/j.1365-2796.2006.01665.x},
  volume       = {260},
  year         = {2006},
}