Effects of pioglitazone on metabolic control and blood pressure: a randomised study in patients with type 2 diabetes mellitus

SUMMARY

Aim: This Swiss multicentre study examined the efficacy and safety of oral pioglitazone in patients with type 2 diabetes.

Methods: Patients were randomised to pioglitazone at once-daily doses of 30mg for 20 weeks (n = 76), 30 mg for 12 weeks followed by 45 mg for 8 weeks (n = 74), or 45 mg for 20 weeks (n = 84); 94.9% of patients completed 12 weeks and 88.9% completed all 20 weeks. Almost all (96.6%) patients received pioglitazone in combination with other anti-diabetic treatments.

Results: Mean HbA1c at baseline was 8.8 ± 1.2%, and changes to endpoint were −1.1 ± 1.1%, −1.1 ± 1.4% and −0.9 ± 1.6%, respectively for the three dose groups (p < 0.001 for each group). Triglyceride concentrations decreased in each group and the overall mean change during the study was −0.58 mmol/l (p < 0.001 versus baseline). HDL-cholesterol increased, with an overall mean change of 0.10 mmol l⁻¹ (p < 0.001 versus baseline). Blood pressure decreased from baseline, particularly for hypertensive patients with mean changes: systolic -10mmHg, p < 0.001, diastolic-8mmHg, p < 0.001 versus baseline. Serum alanine aminotransferase and γ-glutamyl transferase concentrations were significantly (p < 0.001 for each) reduced during the study.

Conclusions: The study demonstrates the efficacy of pioglitazone 30 mg day⁻¹ and 45 mg day⁻¹ in the treatment of type 2 diabetes, with an improved lipid profile and decreased blood pressure in addition to improved glycaemic control.

Key words: :

• Blood pressure
• HbA
• Lipid profile
• Pioglitazone