Combined Pioglitazone and Metformin Treatment Maintains the Beneficial Effect of Short-Term Insulin Infusion in Patients with Type 2 Diabetes: Results from a Pilot Study

Abstract

Our pilot study demonstrated that a beneficial effect of a short-term intravenous insulin application on glycemic control was effectively maintained by pioglitazone/metformin treatment for at least 4 months. In addition, the oral therapy significantly improved cardiovascular risk parameters.

High-Sensitivity C-Reactive Protein Predicts Cardiovascular Risk in Diabetic and Nondiabetic Patients: Effects of Insulin-Sensitizing Treatment with Pioglitazone

“…Indeed, studies have demonstrated that pioglitazone therapy benefits individuals with elevated hs-CRP values. [46][47][48][49][50][51][52][53] 54 published data of 136 Japanese type 2 diabetes patients showing that pioglitazone treatment (30 mg daily for 3 months) significantly reduced hyperglycemia and hs-CRP relative to an untreated control group. In fact, a stratification into glycemic control responders [>1% of reduction in hemoglobin A1c (HbA1c)] and nonresponders revealed that CRP reduction with pioglitazone occurred independently of changes in parameters related to glucose metabolism.…”

“…Improvements in hs-CRP values were demonstrated at end point only after continued glitazone intake (p < 0.05 vs baseline). 52 Analyses of data from the IRIS V study, a large populationbased observational trial in a routine clinical setting, substantiated the favorable effects of the insulin-sensitizing agent on systemic chronic inflammation: 1170 subjects received pioglitazone alone or in combination with their previous treatment (acarbose, sulfonylurea drugs, and/or metformin). After 20 weeks, hs-CRP levels had decreased significantly with pioglitazone therapy (baseline 3.3 ± 1.0 mg/liter vs end point 2.8 ± 2.3 mg/liter, p < 0.01).…”

“…Indeed, studies have demonstrated that pioglitazone therapy benefits individuals with elevated hs-CRP values. [46][47][48][49][50][51][52][53] Table 1 provides an overview of the growing number of clinical trials that have examined the impact of pioglitazone on inflammatory processes as measured by hs-CRP levels in various clinical settings. In 2003, Satoh et al 54 published data of 136 Japanese type 2 diabetes patients showing that pioglitazone treatment (30 mg daily for 3 months) significantly reduced hyperglycemia and hs-CRP relative to an untreated control group.…”