The effect of pioglitazone on weight, lipid profile and liver enzymes in type 2 diabetic patients

Aghamohammadzadeh, Naser; Niafar, Mitra; Abdolahinia, Elham Dalir; Najafipour, Farzad; Gharebaghi, Saeed Mohamadzadeh; Adabi, Khadijeh; Abdolahinia, Elaheh Dalir; Ahadi, Hamid-Reza

doi:10.1177/2042018815574229

Cited by 35 publications

(28 citation statements)

References 32 publications

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“…Therefore, pioglitazone prevents the progression of type 2 diabetes, an effect that may be strongly linked to its ability to improve dysregulation of adipocytokines. Repeated administration of pioglitazone significantly improved hyperlipidemia, but increased visceral fat and body weights without affecting food intake, which is consistent with findings from clinical studies on type 2 diabetes (Aghamohammadzadeh et al, ; Ito et al, ). Increased fat and body weights during pioglitazone treatment has been attributed to promotion of fatty acid storage and uptake in adipose tissue via the regulation of a number of genes with roles in fatty acid uptake (fatty acid transport protein 1, adipocyte fatty acid‐binding protein, and CD36) and adipogenesis (sterol regulatory element‐binding protein‐1 and stearoyl‐CoA desaturase 1) (Wu et al, ).…”

Section: Discussionsupporting

confidence: 87%

SGLT2 inhibitor ipragliflozin alone and combined with pioglitazone prevents progression of nonalcoholic steatohepatitis in a type 2 diabetes rodent model

Tahara

Takasu

2019

Physiol Rep

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Nonalcoholic steatohepatitis (NASH) has become the most common cause of chronic liver disease worldwide in recent years. The pathogenesis of NASH is closely linked to metabolic diseases such as insulin resistance, obesity, dyslipidemia, and type 2 diabetes. However, there is currently no pharmacological agent for preventing the progression of NASH. Sodium–glucose cotransporter (SGLT) 2 inhibitors increase urinary glucose excretion by inhibiting renal glucose reabsorption, and improve various pathological conditions of type 2 diabetes, including insulin resistance. In the present study, we examined the effects of ipragliflozin, a SGLT2‐selective inhibitor, alone and in combination with pioglitazone on NASH in high‐fat diet‐fed KK/Ay type 2 diabetic mice. Type 2 diabetic mice with NASH exhibited steatosis, inflammation, and fibrosis in the liver as well as hyperglycemia, insulin resistance, and obesity, features that are observed in human NASH. Four‐week repeated administration of ipragliflozin (0.1–3 mg/kg) led to significant improvements in hyperglycemia, insulin resistance, and obesity in addition to hyperlipidemia and liver injury including hepatic steatosis and fibrosis. Moreover, ipragliflozin reduced inflammation and oxidative stress in the liver. Repeated administration of pioglitazone (3–30 mg/kg) also significantly improved various parameters of diabetes and NASH, excluding obesity. Furthermore, combined treatment comprising ipragliflozin (1 mg/kg) and pioglitazone (10 mg/kg) additively improved these parameters. These findings indicate that the SGLT2‐selective inhibitor ipragliflozin improves hyperglycemia as well as NASH in type 2 diabetic mice. Therefore, treatment with ipragliflozin monotherapy or coadministered with pioglitazone is expected to be a potential therapeutic option for the treatment of type 2 diabetes with NASH.

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Section: Discussionsupporting

confidence: 87%

SGLT2 inhibitor ipragliflozin alone and combined with pioglitazone prevents progression of nonalcoholic steatohepatitis in a type 2 diabetes rodent model

Tahara

Takasu

2019

Physiol Rep

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“…Pioglitazone reduces the risk of cardiovascular events, which is important because type 2 diabetic patients are greatly burdened by cardiovascular disease . However, pioglitazone has adverse effects of fluid retention, body weight gain and heart failure . Sodium‐glucose cotransporter 2 (SGLT‐2) inhibitor, a new class of oral anti‐hyperglycaemic agent, increases urinary glucose excretion by inhibiting renal glucose reabsorption and facilitating net calorie loss .…”

Section: Introductionmentioning

confidence: 99%

“…7 However, pioglitazone has adverse effects of fluid retention, body weight gain and heart failure. 8,9 Sodium-glucose cotransporter 2 (SGLT-2) inhibitor, a new class of oral anti-hyperglycaemic agent, increases urinary glucose excretion by inhibiting renal glucose reabsorption and facilitating net calorie loss. 10 Moreover, the mild osmotic diuresis 10 and caloric loss caused by SGLT-2 inhibitors reduce body weight, oedema and risk of heart failure.…”

Section: Introductionmentioning

confidence: 99%

Sodium‐glucose cotransporter 2 inhibitor plus pioglitazone vs pioglitazone alone in patients with diabetes mellitus: A systematic review and meta‐analysis of randomized controlled trials

Liao¹,

Sue

et al. 2018

Endocrino Diabet & Metabol

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Summary Aims To evaluate the efficacy and safety of combined therapy with sodium‐glucose cotransporter 2 (SGLT‐2) inhibitors plus pioglitazone versus pioglitazone alone in type 2 diabetic patients. Materials and Methods Systematic literature searches were performed across PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and clinicaltrials.gov from 1966 to September 2018 to identify randomized, controlled trials. Mean difference (MD) or odds ratio (OR) was used to evaluate efficacy and safety end‐points (active group vs control group), wherever appropriate. Heterogeneity was assessed by P value of χ 2 statistics and I 2 . Results Four randomized controlled trials with 1411 diabetic patients were included. Pooling data from included trials showed that HbA1c change was significantly larger in both low‐dose SGLT‐2 inhibitors (MD: −0.59%, 95% CI: −0.77 to −0.41%) and high‐dose SGLT‐2 inhibitors (MD: −0.65%, 95% CI: −0.78 to −0.53%) plus pioglitazone than pioglitazone alone in 24‐26 weeks. Favourable outcomes were also found in fasting blood glucose level reduction and more patients achieving HbA1c <7% in SGLT‐2 inhibitor plus pioglitazone (OR: 3.21, 95% CI: 1.99 to 5.16). Also, SGLT‐2 inhibitor plus pioglitazone vs pioglitazone, reduced weight and blood pressure. The risks of death, heart failure, hypoglycaemia and urinary tract infection were not different between active and control groups although genital tract infection was more frequently seen in SGLT‐2 inhibitor group. Conclusions Compared to pioglitazone alone, SGLT‐2 inhibitor plus pioglitazone improved glycaemic control, reduced body weight and lowered blood pressure, but increased genital tract infection.

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“…These drugs do not need renal dose adjustment due to their predominant hepatic metabolism and do not have an increase risk of hypoglycemia . Nevertheless, they should be used with caution in patients on dialysis because their adverse effects include weight gain, fluid retention that may lead to edema and/or heart failure, and increased risk of bone fractures …”

Section: What Therapeutic Options Can Be Used To Treat Hyperglycemia mentioning

confidence: 99%

Is the management of diabetes different in dialysis patients?

Coelho

2018

Seminars in Dialysis

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Diabetes is highly and increasingly prevalent in the dialysis population and negatively impacts both quality and quantity of life. Nevertheless, the best approach to these patients is still debatable. The question of whether the management of diabetes should be different in dialysis patients does not have a clear yes or no answer but is divided into too many sub-issues that should be carefully considered. In this review, lifestyle, cardiovascular risk, and hyperglycemia management are explored, emphasizing the possible pros and cons of a similar approach to diabetes in dialysis patients compared to the general population.

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The effect of pioglitazone on weight, lipid profile and liver enzymes in type 2 diabetic patients

Cited by 35 publications

References 32 publications

SGLT2 inhibitor ipragliflozin alone and combined with pioglitazone prevents progression of nonalcoholic steatohepatitis in a type 2 diabetes rodent model

SGLT2 inhibitor ipragliflozin alone and combined with pioglitazone prevents progression of nonalcoholic steatohepatitis in a type 2 diabetes rodent model

Sodium‐glucose cotransporter 2 inhibitor plus pioglitazone vs pioglitazone alone in patients with diabetes mellitus: A systematic review and meta‐analysis of randomized controlled trials

Is the management of diabetes different in dialysis patients?

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