Drug Reduces Rate of Conversion to Type 2 Diabetes

But pioglitazone also appears to cause weight gain and edema

WEDNESDAY, March 23 (HealthDay News) -- Pioglitazone effectively reduces conversion to type 2 diabetes in people with impaired glucose tolerance, though it may also lead to weight gain and edema, according to research published in the March 24 issue of the New England Journal of Medicine.

Ralph A. DeFronzo, M.D., of the University of Texas Health Science Center in San Antonio, and colleagues randomly assigned 602 patients with impaired glucose tolerance to pioglitazone or placebo to see whether the former reduced the rate of conversion to type 2 diabetes.

After a median follow-up of 2.4 years, the researchers found that the annual incidence of conversion to diabetes was 2.1 percent in the treatment group and 7.6 percent in the control group. They observed conversion to normal glucose tolerance in 48 percent of the patients in the pioglitazone group and 28 percent of those in the control group. Pioglitazone was also associated with significantly lower levels of fasting glucose, two-hour glucose, and HbA1c, as well as decreased diastolic blood pressure, a lower rate of carotid intima-media thickening (P = 0.047), and a larger increase in high-density lipoprotein cholesterol. Patients in the treatment group, however, experienced greater weight gain (3.9 kg versus 0.77 kg) and more frequent edema (12.9 versus 6.4 percent).

"Use of pioglitazone improved diastolic blood pressure, high-density lipoprotein cholesterol levels, and serum levels of alanine aminotransferase and aspartate aminotransferase, and it slowed progression of carotid intima-media thickening. The influence of these effects on long-term diabetic complications remains to be determined," the authors write.

The study was funded in part by Takeda Pharmaceuticals, maker of pioglitazone; several authors disclosed financial relationships with Takeda and/or other pharmaceutical companies.

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