March 24th, 2011
Study Finds Pioglitazone Prevents Progression To Diabetes
Pioglitazone significantly reduces the development of type 2 diabetes in people with impaired glucose tolerance, according to the results of the ACT NOW study published in the New England Journal of Medicine.
Ralph DeFronzo and colleagues randomized 602 patients with impaired glucose tolerance to pioglitazone or placebo. During a median followup of 2.4 years, diabetes developed in 16.7% of the placebo group versus 5% in the pioglitazone group (HR for pioglitazone 0.28, CI 0.16-0.49, p<0.001). The investigators calculated that 18 people needed to be treated for one year to prevent one case of diabetes. In addition to its beneficial effects on glucose metabolism, pioglitazone was associated with a decrease in diastolic blood pressure, reduced CIMT thickening, and increased HDL cholesterol. On a less positive note, pioglitazone caused a significantly larger weight gain (3.9 kg vs 0.77 kg) and more edema than did placebo.
The investigators acknowledged that the effect of pioglitazone on long-term diabetic complications has not been determined.