Pioglitazone Slows Carotid Thickening in Diabetics

Pioglitazone, besides improving glycemic control, also decreases carotid intima-media thickness (IMT) in patients with type 2 diabetes. "We are encouraged by these results because the benefits seen with pioglitazone could, theoretically, lead to an overall reduction in the incidence of heart attack and stroke for people with type 2 diabetes," study co-author Dr. Thomas Forst, from the Institute for Clinical Research and Development in Mainz, Germany, said in a statement.

The study involved 173 patients with type 2 diabetes who were randomized to receive pioglitazone or glimepiride-based treatment for 24 weeks.

During the study period, patients in each group experienced similar improvements in glycemic control, based on HbA1c levels. However, only pioglitazone-treated subjects showed a significant reduction in carotid IMT at 12 and 24 weeks.

Insulin resistance improved significantly in the pioglitazone group, but not in the glimepiride group.

Further analysis showed that the drop in carotid IMT correlated with the improvement in insulin resistance, but was independent of changes in glycemic control, the authors note.

"Our results support the growing body of evidence for an anti-atherogenic effect of PPAR-gamma activators that reach beyond glycemic control and might imply prognostic benefits for patients treated with this class of drugs and especially for patients with type 2 diabetes," the authors conclude.
Circulation 2005;111:2525-2531.
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FACT:
Predicting Type 2 Diabetes in Men: Is waist circumference, waist-to-hip ratio, or BMI the better measure of type 2 diabetes risk in men? Overall obesity measured with BMI and abdominal obesity determined by waist circumference appear to be similarly effective independent predictors of type 2 diabetes risk, but both were stronger predictors than waist-to-hip ratio, according to a study published in the March 1, 2005 American Journal of Clinical Nutrition. Investigators reviewed data from 27,270 men enrolled in the Health Professionals Follow-Up Study. During 13-year follow-up, 884 men developed type 2 diabetes. The researchers noted that the currently recommended maximum waist circumference for men (102 cm) may need to be lowered (perhaps to 95 cm according to this data).

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