Effect of Pioglitazone Compared with Metformin on Glycemic Control and Indicators of Insulin Sensitivity in Recently Diagnosed Patients with Type 2 Diabetes

• DOI: 10.1210/jc.2002-021786
• Publication Date: 2003-04-04T19:04:48Z
• Authors: Imre Pavo; György Jermendy; Tamas T. Varkonyi; Zsuzsa Kerenyi; Andras Gyimesi; Sergej Shoustov; Marina Shestakova; Matthias Herz; Don Johns; Belinda J. Schluc...; Andreas Festa; Meng H. Tan
• Keywords: Pioglitazone; Thiazolidinedione; Biguanide; Acarbose

Pioglitazone, a thiazolidinedione, improves glycemic control primarily by increasing peripheral insulin sensitivity in patients with type 2 diabetes, whereas metformin, biguanide, exerts its effect decreasing hepatic glucose output. In the first head-to-head, double-blind clinical trial comparing these two oral antihyperglycemic medications (OAMs), we studied of 32-wk monotherapy on and 205 recently diagnosed diabetes who were naive to OAM therapy. Subjects randomized either 30 mg pioglitazone or 850 metformin daily titrations upward 45 (77% patients) 2550 (73% patients), as indicated, achieve fasting plasma levels less than 7.0 mmol/liter (126 mg/dl). Pioglitazone was comparable improving measured hemoglobin A1C glucose. At endpoint, significantly more effective indicators sensitivity, determined reduction serum (P = 0.003) analysis homeostasis model assessment for (HOMA-S; P 0.002). Both therapies well tolerated. Therefore, are equally efficacious regard control, but they exert different effects due differing mechanisms action. The pronounced improvement pioglitazone, compared OAM-naive, may be interest further evaluation.