Pioglitazone Restores Endothelial Function in Patients with Type 2 Diabetes Treated with Insulin

Sunil Asnani, Biju Kunhiraman, Ali Jawa, Donald Akers, David Lumpkin, Vivian Fonseca
2006 Metabolic Syndrome and Related Disorders  
The primary aim of this study was to evaluate the effect of pioglitazone on endothelial function, as assessed by flow-mediated dilatation (FMD) nitroglycerine-induced dilatation (NID) in patients with type 2 diabetes mellitus treated with insulin. A randomized double-blind placebo-controlled trial involved 20 patients with insulin-treated type 2 diabetes. Patients received either pioglitazone 30 mg or placebo for 4 months. FMD, NID, and HbA1c were measured before and after 4 months of
more » ... months of treatment. HbA1c decreased from 10.0 (± 2.3) to 8.4 (± 2.0) in the pioglitazone group, a statistically significant improvement in glycemic control (p = 0.018). HbA1c was unchanged in the placebo group (p = 0.477). Endothelial function as assessed by FMD significantly improved from 10.1 (± 4.0)% to 14.6 (± 6.2)% in the pioglitazone group (p = 0.036) as compared to the placebo group (p = 0.705). There was a trend towards improvement in the NID in the pioglitazone group (from 13.3 ± 8.0% to 18.9 ± 5.4%; p = 0.056). In insulin-treated patients with type 2 diabetes, the addition of pioglitazone improves endothelial function, as measured by FMD. Addition of pioglitazone to insulin in type 2 diabetes patients may favorably impact vascular function in diabetes, even after many years of insulin resistance and hyperglycemia.
doi:10.1089/met.2006.4.179 pmid:18370736 fatcat:luapcaw4a5b5rm2h5heze46gmi