Metabolic effects of pioglitazone and rosiglitazone in patients with diabetes and metabolic syndrome treated with metformin

G. Derosa, A. D'Angelo, P. D. Ragonesi, L. Ciccarelli, M. N. Piccinni, F. Pricolo, S. A T Salvadeo, L. Montagna, A. Gravina, I. Ferrari, S. Paniga, A. F G Cicero

Research output: Contribution to journalArticle

Abstract

Background: Metformin is considered the gold standard for type 2 diabetes treatment as monotherapy and in combination with sulphonylureas and insulin, whereas the combination of metformin with thiazolidinediones is relatively less studied. The aim of the present study was to assess the differential effect on glycaemic metabolism and lipid variables of the combination of metformin plus pioglitazone or metformin plus rosiglitazone in diabetic patients with metabolic syndrome. Methods: All patients began metformin and were randomized to receive pioglitazone or rosiglitazone for 12 months. We assessed body mass index, glycated haemoglobin, fasting plasma glucose, postprandial plasma glucose, fasting plasma insulin, postprandial plasma insulin, homeostasis model assessment index, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein A-I, and apolipoprotein B. Results: Significant decreases in glycated haemoglobin, fasting plasma glucose, postprandial plasma glucose, fasting plasma insulin, and postprandial plasma insulin were seen after 9 and 12 months in both groups. Homeostasis model assessment index improved at 12 months in both groups. Significant total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, apolipoprotein A-I, and apolipoprotein B improvement was observed in pioglitazone group after 12 months, but not in the rosiglitazone group. These variations were significant between groups. Conclusion: The combination of metformin plus thiazolidinediones was able to improve glycaemic control compared with previous therapy. Pioglitazone was associated with a significant improvement in lipid and lipoprotein variables.

Original languageEnglish
Pages (from-to)79-86
Number of pages8
JournalInternal Medicine Journal
Volume37
Issue number2
DOIs
Publication statusPublished - Feb 2007

Keywords

  • Lipid
  • Metabolic syndrome
  • Thiazolidinedione
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine

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    Derosa, G., D'Angelo, A., Ragonesi, P. D., Ciccarelli, L., Piccinni, M. N., Pricolo, F., Salvadeo, S. A. T., Montagna, L., Gravina, A., Ferrari, I., Paniga, S., & Cicero, A. F. G. (2007). Metabolic effects of pioglitazone and rosiglitazone in patients with diabetes and metabolic syndrome treated with metformin. Internal Medicine Journal, 37(2), 79-86. https://doi.org/10.1111/j.1445-5994.2007.01238.x