| The addition of pioglitazone in type 2 diabetics poorly controlled on insulin therapy: a meta-analysis. | |
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MedLine Citation:
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PMID: 20816593 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To quantify the effect of a pioglitazone on glycemic control and lipid parameters, as well as the risk of adverse events when incorporated into the treatment regimen of patients with type 2 diabetes inadequately controlled on insulin. METHODS: The electronic databases PubMed, Embase and The Cochrane Library were searched systematically to identify randomized controlled trials (RCTs) of pioglitazone therapy in patients with type 2 diabetes mellitus (DM) inadequately controlled after treatment with insulin. Data on change of haemoglobin A1C (HbA1c), fasting plasma glucose (FPG), lipid parameters and risk of hypoglycemic, edema events were extracted from each study and pooled according to fixed effect model or random effect model in meta-analyses. RESULTS: Four RCTs including 1767 patients were included. The pooled estimate of change in HbA1c from baseline was 1.22% (95% CI 1.01-1.44, p<0.001 vs. baseline) and of change in FPG from baseline was 1.63 mmol/l (95% CI 0.75-2.50, p<0.001 vs. baseline). Pioglitazone significantly increased high-density lipoprotein cholesterol (HDL-c) level (0.2 mmol/L, 95%CI: 0.13-0.28) and low-density lipoprotein cholesterol (LDL-c) level (0.10 mol/L, 95%CI: 0.09-0.17), and lowered triglyceride (TG) level (0.05 mmol/L, 95%CI: 0.01-0.09). The odds of experiencing a hypoglycemic event in pioglitazone-treated arms was significantly higher than comparator treatments (RR=1.57, 95% CI 1.12-2.20, p<0.001). The case was the same with edema (RR=2.42, 95% CI 1.67-3.50, p<0.001). CONCLUSIONS: Our study implied that in patients with type 2 DM whose control is inadequate on insulin therapy, the additional pioglitazone could significantly improve glucose metabolism and might have a positive effect on important components of the lipid profile, which may have important implications in reducing the risk of cardiovascular disease, a major long-term complication in type 2 diabetes mellitus. Besides, the adverse events (AEs) were well tolerated. |
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Authors:
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Aihua Tan; Yunfei Cao; Ning Xia; Zengnan Mo; Feng Gao |
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Publication Detail:
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Type: Journal Article; Meta-Analysis |
Journal Detail:
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Title: European journal of internal medicine Volume: 21 ISSN: 1879-0828 ISO Abbreviation: Eur. J. Intern. Med. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-06 Completed Date: 2010-12-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9003220 Medline TA: Eur J Intern Med Country: Netherlands |
Other Details:
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Languages: eng Pagination: 398-403 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010. Published by Elsevier B.V. |
Affiliation:
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Guangxi Medical University, Nanning, Guangxi, PR China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiovascular Diseases
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epidemiology Diabetes Mellitus, Type 2 / drug therapy*, epidemiology Drug Therapy, Combination Humans Hypoglycemic Agents / administration & dosage*, adverse effects Insulin / administration & dosage*, adverse effects Risk Factors Thiazolidinediones / administration & dosage*, adverse effects |
| Chemical | |
Reg. No./Substance:
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0/Hypoglycemic Agents; 0/Thiazolidinediones; 11061-68-0/Insulin; 111025-46-8/pioglitazone |
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