Issue 153 Item 10 Pioglitazone Improves Insulin Sensitivity Compared To Metformi

Pioglitazone exerts a greater benefit on insulin sensitivity in recently diagnosed patients with type 2 diabetes. Pioglitazone and metformin improve glycemic control to a similar extent, but pioglitazone exerts a greater benefit on insulin sensitivity in recently diagnosed patients with type 2 diabetes who have not previously received oral antihyperglycaemics Researchers from Lilly Research Laboratories, Indianapolis, Indiana, United States, treated 205 recently diagnosed type 2 diabetics who had not previously received oral antihyperglycaemics. Treatment began with either 30 mg pioglitazone or 850 mg metformin daily for 32 weeks. To attain fasting plasma glucose levels of less than 7.0 mmol per litre, the researchers titrated the doses daily, increasing pioglitazone to 45 mg in 77% of patients, and metformin to 2550 mg in 73%.

Pioglitazone and metformin produced comparable effects on haemoglobin A1C and fasting plasma glucose levels, suggesting that the drugs improved glycaemic control to a similar extent. However, at the end of the study, pioglitazone reduced fasting serum insulin levels and improved the homeostasis model assessment for insulin sensitivity to a greater extent than metformin. This suggests that pioglitazone improves insulin sensitivity more effectively than metformin. Pioglitazone and metformin were well tolerated. J Clin Endocrinol Metab 2003;88:4:1637-45

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