Pioglitazone Therapy Does Not Affect Coronary Flow in Diabetics

Pioglitazone therapy did not alter resting or adenosine-stimulated myocardial blood flow, or have an effect on coronary flow reserve. Although pioglitazone therapy improves several cardiovascular risk factors in patients with insulin-requiring type 2 diabetes, it does not affect coronary flow, according to a report in the May issue of Diabetes Care.

Previous reports have suggested that insulin resistance may impair coronary endothelial function. Thus, treatment with a pioglitazone, an insulin-sensitizing agent, could, in theory, improve coronary flow.

To investigate, Dr. Marcelo F. DiCarli, from the Brigham and Women’s Hospital in Boston, and colleagues used positron emission tomography to assess myocardial blood flow in 16 subjects with insulin-treated type 2 diabetes who were randomized to receive pioglitazone or placebo for 3 months.

Pioglitazone-treated patients experienced a drop in HbA1c levels, whereas control patients experienced an increase (p = 0.009), the researchers note. In addition, pioglitazone therapy was linked to a significant improvement in triglyceride and HDL concentrations.

Despite these beneficial effects, pioglitazone therapy did not alter resting or adenosine-stimulated myocardial blood flow, or have an effect on coronary flow reserve.

On regression analysis, lower glucose levels at the time of the study were linked to higher coronary flow reserve, the researchers point out.

Further studies are currently underway to clarify the beneficial effect that pioglitazone and other thiazolidinediones have on clinical cardiovascular events.

Diabetes Care 2005;28:1145-1150

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FACT: Poor glycemic Control Makes Diabetics Depressed: A study has identified an increased incidence of depression among Hispanic diabetics with poor glycemic control (PGC). They found a correlation between PGC and advancing categories of depression severity in a group of more than 200 Hispanics with diabetes.
Journal of General Internal Medicine, May 2005