Pioglitazone - the new cornerstone of diabetic care?

Abstract

Pioglitazone [‘Actos’], a new thiazolidinedione derivative, improves glycaemic control and lipid profiles in patients with type 2 diabetes mellitus when used as monotherapy or in combination treatment. A trial of once-daily pioglitazone monotherapy showed significant improvement in glycosylated haemoglobin (HbA _1c ) and fasting blood glucose levels, and the degree of improvement was dose-related. Other studies showed that pioglitazone in combination with metformin or a sulfonylurea improved glycaemic control in patients with type 2 diabetes who were poorly controlled on monotherapy. The patients were also dyslipidaemic, and the studies showed a consistent pattern of improvement in lipid profile, characterised by a decline in triglyceride levels and an increase in HDL-cholesterol levels. Importantly, pioglitazone has not been associated with hepatotoxicity. The studies were presented at the 59th Annual Meeting of the American Diabetes Association [ San Diego, US; June, 1999 ].