The Pioglitazone’s Efficacy In Patients With Type2Diabetes And Hyperuricemia

With the increase of living standards, more and more people payattention to hyperuricemia.Number of clinical studies and epidemiologicalinvestigations showed that closely related to hyperuricemia and insulinresistance (IR), IR has become a common risk factor for type2diabetes andhyperuricemia.In recent years, thiazolidinediones(TZDs) as a new class ofinsulin sensitizers used in clinical widely. TZDs activated downstream genetranscription through activation of peroxisome proliferator activated receptorsPPARr, regulated a series of genes that participate in glucose and lipidmetabolism, by enhancing the sensitivity to insulin in muscle, liver, and fattissue, and enhancing peripheral glucose removal rate and suppress the outputof glycogen, thereby improved insulin resistance.Comparative study ofdifferent regimens of oral hypoglycemic drugs or insulin treatment on theimpact of serum uric acid is also small, the study in diabetic patients withhyperlipidemia.This article aims to observe the two different regimens ofinsulin sensitizing agent pioglitazone or insulin therapy on renal function andserum uric acid, patients with type2diabetes mellitus and hyperlipidemiatreatment programs provide a reference.Objective: To compare the effects of pioglitazone or insulin therapy onblood glucose and serum uric acid in type2diabetes.Materials and methods:Select treatment in the hospital in February2010to2011February，One hundred and thirty-three patients with type2diabetesmellitus complicated with hyperuricemia randomly divided into3groups.Fasting glucose,2-hour glucose, glycation hemoglobin(HbA1c), serum uricacid, microalbuminuria(MAU), serum creatinine(Cr), total cholesterol(TC) andtriglyceride(TG) were measured before and after12weeks of treatment with pioglitazone, insulin or conventional treatment.Applied SPSS17.0statisticalsoftware for statistical analysis to observations, measurement data using（x±s）, the two groups were compared by t test, a few more groups of themeans were compared by analysis of variance.Results: Fasting glucose,2-hour glucose, HbA1c, serum uric acid,decreased significantly at12weeks in patients receiving pioglitazone (P<0.05).Fasting glucose,2-hour glucose and HbA1c decreased significantly at12weeksin patients receiving insulin(P<0.05).At12weeks, the insulin group had lowerfasting glucose,2-hour glucose and HbA1c, than the pioglitazone group and theinsulin group(P<0.05). The pioglitazone group had lower serum uric acid thanthe insulin group.(P<0.05). The conventional treatment.group had lower serumuric acid than the other group(P<0.05).Conclusions: The strongest of the hypoglycemic effect of insulin group.;Pioglitazone can reduce fasting and postprandial blood glucose effectively, andhave good results in reducing serum uric acid. In the46patients,3patients hadlower extremity edema, given diuretics swelling improved after two weeks,Thedrug didn’t cause low blood sugar alone. There is no other clinical side effects,its safety still needs a large clinical sample of long-term observational study.