Evaluation Of Pioglitazone In Type 2 Diabetes With Metabolic Syndrome

Objective:To investigate the effect of piolitazone in the treatment of type 2 diabetes and type 2 diabetes with metabolic syndrome.Methods:Altogether 145 type 2 diabetes patients(age 35-75 years, duration 5 to 6 years)were enrolled.According to the definition of metabolic syndrome by IDF,they were divided into Group 1(type 2 diabetes with metabolic syndrome group)and Group 2(type 2 diabetes group).Then each group was randomized to receive oral pioglitazone (Trial subgroup)or placebo(Control subgroup)on the basis of the original regimen for 1 year.Thus we divided the 145 patients into four subgroups:T1 subgroup(type 2 diabetes with metabolic syndrome group with with pioglitazone,n=23),C1 subgroup(type 2 diabetes with metabolic syndrome group with placebo,n=23),T2 subgroup(type 2 diabetes group with pioglitazone,n=49).,and C2 subgroup(type 2 diabetes group with placebo,n=50).Blood was drawn regularly to determine fasting plasma glucose and insulin,2h postprandial blood glucose,glycosylated hemoglobin(HbA1c)and serum lipid profiles.Results:(1)Totally there were 134 patients completed the 1-year observation.The number of patients who had completed the observation in T1,C1,T2 and C2 subgroups was 21,22,46 and 45 respectively. (2)After with pioglitazone for one year,the levels of FBS,PBS,HbA1c, Fins,HOMA-IR and TC all decreased significantly both in T1 and T2 subgroups compared with the baseline respectively(all P＜0.05);Insulin resistance was relieved in both subgroups.While in the two control subgroups(C1 and C2 subgroups),after one-year with placebo,theβcell function declined and blood glucose increased compared with the baseline(all P＜0.05).(3)Compared with the control subgroups(T1 subgroup vs C1 subgroup,T2 subgroup vs C2 subgroup,respectively), the levels of SBP,DBP,FBS,PBS,HbA1c and theβcell function in the trial subgroups were all improved significantly(all P＜0.05).Compared with T2 subgroup,the levels of SBP,DBP,FBS,PBS,HbA1c were all decreased and insulin resistance and theβcell function were both improved significantly in T1 subgroup(all P＜0.05).Conclusion:Pioglitazone further improve the insulin resistance and hyperglycemia of T2DM treating with SUs and metformin; pioglitazone has better glucose lower effect on the T2DM with MS and this may related with the improvement of the insulin resistance and B cell function.