| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Department of Medicine I, Rudolfstiftung Hospital (G.S.), A-1030 Vienna, Austria; Oxford Center for Diabetes, Endocrinology, and Metabolism, Radcliffe Infirmary (D.R.M.), Oxford, OX2 6HE, United Kingdom; Clinique d’Endocrinologie, Hotel Dieu (B.C.), 44093 Nantes, France; Center for Clinical Studies, Gesellschaft für Wissens- und Technologietransfer, Technical University Dresden (M.H.), Dresden D-01307, Germany; and Internal Medicine and Metabolic Diseases Department, Universita di Perugia (P.B.), 06126 Perugia, Italy
Address all correspondence and requests for reprints to: Dr. G. Schernthaner, Department of Medicine I, Rudolfstiftung Hospital, Juchgasse 25, A-1030 Vienna, Austria. E-mail: guntram.schernthaner{at}wienkav.at.
Pioglitazone increases the insulin sensitivity of peripheral tissues and may provide an alternative first-line treatment for type 2 diabetes. This study compared metabolic control in drug-naive type 2 diabetes patients given either pioglitazone or metformin. Eleven hundred and ninety-nine patients with poorly controlled type 2 diabetes mellitus [glycosylated hemoglobin (HbA1c), 7.5–11%; normal, 4.3–6.1%] were randomized to receive either pioglitazone (
45 mg/d) or metformin (850 mg, three times daily). HbA1c, fasting plasma glucose (FPG), insulin levels, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol, triglycerides, free fatty acids, and urinary albumin/creatinine ratio were measured. Mean HbA1c decreased in both treatment groups from baseline to wk 52 (–1.4% and –1.5%). Significantly greater mean reductions in FPG were observed in the pioglitazone group (–45.0 mg/dl; –2.5 mmol/liter) than in the metformin (–39.6 mg/dl; –2.2 mmol/liter) group (P = 0.016). Favorable changes in triglycerides and HDL-C were more pronounced with pioglitazone. Although low density lipoprotein cholesterol and TC levels increased with pioglitazone, TC/HDL-C ratios decreased similarly with both treatments. The urinary albumin/creatinine ratio was reduced by 19% with pioglitazone treatment, but remained unchanged with metformin therapy (–1%; P = 0.002). There was an increase in body weight of 1.9 kg in the pioglitazone group and a decrease of 2.5 kg in the metformin group. The overall frequency of adverse events was similar between treatment groups, but adverse event profiles were different between treatment groups. HbA1c reduction is similar after pioglitazone and metformin monotherapies, but differences in FPG, plasma lipids, and adverse effects between the two compounds may influence decision-making in individual prescribers.
Find additional patient-related information at:
This article has been cited by other articles:
 |
|
 |
|
  T. Miyata and C. van Ypersele de Strihou Translation of basic science into clinical medicine: novel targets for diabetic nephropathy Nephrol. Dial. Transplant., May 1, 2009; 24(5): 1373 - 1377. [Full Text] [PDF]
|
|
|
|
 |
|
 I. W Campbell Review: Durable glycaemia -- the promised land The British Journal of Diabetes & Vascular Disease, March 1, 2009; 9(2): 53 - 63. [Abstract] [PDF]
|
|
|
|
 |
|
 E. Selvin, S. Bolen, H.-C. Yeh, C. Wiley, L. M. Wilson, S. S. Marinopoulos, L. Feldman, J. Vassy, R. Wilson, E. B. Bass, et al. Cardiovascular Outcomes in Trials of Oral Diabetes Medications: A Systematic Review Arch Intern Med, October 27, 2008; 168(19): 2070 - 2080. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Heutling, H. Schulz, I. Nickel, J. Kleinstein, P. Kaltwasser, S. Westphal, F. Mittermayer, M. Wolzt, K. Krzyzanowska, H. Randeva, et al. Asymmetrical Dimethylarginine, Inflammatory and Metabolic Parameters in Women with Polycystic Ovary Syndrome before and after Metformin Treatment J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 82 - 90. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W.S. Leslie, C.R. Hankey, and M.E.J. Lean Weight gain as an adverse effect of some commonly prescribed drugs: a systematic review QJM, July 1, 2007; 100(7): 395 - 404. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. V. d. Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) Eur. Heart J. Suppl., June 1, 2007; 9(suppl_C): C3 - C74. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Erdmann, J. A. Dormandy, B. Charbonnel, M. Massi-Benedetti, I. K. Moules, A. M. Skene, and on behalf of the PROactive Investigators The Effect of Pioglitazone on Recurrent Myocardial Infarction in 2,445 Patients With Type 2 Diabetes and Previous Myocardial Infarction: Results From the PROactive (PROactive 05) Study J. Am. Coll. Cardiol., May 1, 2007; 49(17): 1772 - 1780. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Schernthaner Kidney disease in diabetology Nephrol. Dial. Transplant., March 1, 2007; 22(3): 703 - 707. [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. Van den Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD) Eur. Heart J., January 1, 2007; 28(1): 88 - 136. [Full Text] [PDF]
|
|
|
|
 |
|
 R. A Ajjan and P. J Grant Cardiovascular disease prevention in patients with type 2 diabetes: the role of oral anti-diabetic agents Diabetes and Vascular Disease Research, December 1, 2006; 3(3): 147 - 158. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Zanchi, C. Perregaux, M. Maillard, D. Cefai, J. Nussberger, and M. Burnier The PPAR{gamma} agonist pioglitazone modifies the vascular sodium-angiotensin II relationship in insulin-resistant rats Am J Physiol Endocrinol Metab, December 1, 2006; 291(6): E1228 - E1234. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Boulanger, R. Mansouri, J. F. Gautier, and D. Glotz Are peroxisome proliferator-activated receptors new therapeutic targets in diabetic and non-diabetic nephropathies? Nephrol. Dial. Transplant., October 1, 2006; 21(10): 2696 - 2702. [Full Text] [PDF]
|
|
|
|
|
|
F. Orio Jr., S. Palomba, T. Cascella, B. De Simone, F. Manguso, S. Savastano, T. Russo, A. Tolino, F. Zullo, G. Lombardi, et al. Improvement in Endothelial Structure and Function after Metformin Treatment in Young Normal-Weight Women with Polycystic Ovary Syndrome: Results of a 6-Month Study J. Clin. Endocrinol. Metab., November 1, 2005; 90(11): 6072 - 6076. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. R Matthews and T. M Wallace Review: Sulphonylureas and the rise and fall of beta-cell function The British Journal of Diabetes & Vascular Disease, July 1, 2005; 5(4): 192 - 196. [Abstract] [PDF]
|
|
|
|
|
|
I. W Campbell Pioglitazone -- an oral antidiabetic agent and metabolic syndrome modulator. Can theory translate into practice? The British Journal of Diabetes & Vascular Disease, July 1, 2005; 5(4): 209 - 216. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Ceriello, D. Johns, M. Widel, D. J. Eckland, K. J. Gilmore, and M. H. Tan Comparison of Effect of Pioglitazone With Metformin or Sulfonylurea (Monotherapy and Combination Therapy) on Postload Glycemia and Composite Insulin Sensitivity Index During an Oral Glucose Tolerance Test in Patients With Type 2 Diabetes Diabetes Care, February 1, 2005; 28(2): 266 - 272. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Metformin vs. Pioglitazone as Initial Treatment for Diabetes Journal Watch (General), January 14, 2005; 2005(114): 2 - 2. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
