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Defeat Diabetes: Pioglitazone/Metformin Therapy Enhances Glycemic Control

Pioglitazone/Metformin Therapy Enhances Glycemic Control

posted 11/14/02

Significant Improvement Seen in a Leading Indicator Of Cardiovascular Disease

Diabetes patients taking the insulin sensitizer pioglitazone HCl in combination with metformin experienced significantly greater improvement in triglyceride levels than patients taking rosiglitazone and metformin, according to the results of a new multi-center, retrospective study being presented last week at the 193rd Meeting of the Society for Endocrinology in London. Patients with diabetes have an increased risk of morbidity and mortality due to heart disease and stroke, and an elevated triglyceride level is a leading risk factor associated with these conditions.

Results from this retrospective review -- Impact of Pioglitazone and Rosiglitazone on Risk Factors for Cardiovascular Disease, or IMPROVE -- showed that patients treated with pioglitazone and metformin experienced a statistically significant 19.8 percent decline from baseline in their triglyceride levels, while those taking the rosiglitazone/metformin combination had a 10.8 percent increase in triglyceride levels over the same period. Blood sugar levels decreased in a similar manner for both study groups.

"These findings are particularly significant because of the link between diabetes and cardiovascular disease," said Anne Peters Harmel, MD, one of the authors of the study and Professor of Clinical Medicine, Keck School of Medicine, University of Southern California. "Diabetes dramatically increases a person's risk for heart disease and stroke, and it is important that we learn which therapies can potentially minimize that risk by improving clinical risk factors for cardiovascular disease."

The IMPROVE study, conducted by Health Economics Research, was based on a national, multi-center, retrospective chart review of 193 similar patients with type 2 diabetes, drawn from 318 endocrinology practices across the U.S. Ninety-seven patients received the combination pioglitazone and metformin and 96 patients received the combination rosiglitazone and metformin.

Only patients in the pioglitazone-metformin group experienced a drop in triglyceride levels. Triglycerides dropped a statistically significant 19.8 percent from baseline in the pioglitazone-metformin group, while those in the rosiglitazone-metformin group increased by 10.8 percent. In addition, study results showed combination therapy with pioglitazone significantly improved lipid profiles by increasing mean HDL ("good") cholesterol by 7 percent from baseline. Among patients receiving combination therapy with rosiglitazone, the increase in mean HDL cholesterol was not significant. Declines in blood sugar did not differ between the study groups.

"It is vitally important to manage not only the blood sugar levels of diabetes patients, but clinical risk factors for cardiovascular disease as well, including high cholesterol and triglyceride levels," said Albert Marchetti, MD, Vice President and Director of Medical Research for the Professional Postgraduate Services division of Health Economics Research. "Pioglitazone in combination with metformin appears to help patients realize greater lipid improvement, which in turn, may help patients minimize their risk for cardiovascular disease."

Source: Diabetes In Control Dot Dom.

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