PMID- 20816593
OWN - NLM
STAT- MEDLINE
DCOM- 20101230
LR  - 20181201
IS  - 1879-0828 (Electronic)
IS  - 0953-6205 (Linking)
VI  - 21
IP  - 5
DP  - 2010 Oct
TI  - The addition of pioglitazone in type 2 diabetics poorly controlled on insulin 
      therapy: a meta-analysis.
PG  - 398-403
LID - 10.1016/j.ejim.2010.03.018 [doi]
AB  - AIM: To quantify the effect of a pioglitazone on glycemic control and lipid 
      parameters, as well as the risk of adverse events when incorporated into the 
      treatment regimen of patients with type 2 diabetes inadequately controlled on 
      insulin. METHODS: The electronic databases PubMed, Embase and The Cochrane 
      Library were searched systematically to identify randomized controlled trials 
      (RCTs) of pioglitazone therapy in patients with type 2 diabetes mellitus (DM) 
      inadequately controlled after treatment with insulin. Data on change of 
      haemoglobin A1C (HbA1c), fasting plasma glucose (FPG), lipid parameters and risk 
      of hypoglycemic, edema events were extracted from each study and pooled according 
      to fixed effect model or random effect model in meta-analyses. RESULTS: Four RCTs 
      including 1767 patients were included. The pooled estimate of change in HbA1c 
      from baseline was 1.22% (95% CI 1.01-1.44, p<0.001 vs. baseline) and of change in 
      FPG from baseline was 1.63 mmol/l (95% CI 0.75-2.50, p<0.001 vs. baseline). 
      Pioglitazone significantly increased high-density lipoprotein cholesterol (HDL-c) 
      level (0.2 mmol/L, 95%CI: 0.13-0.28) and low-density lipoprotein cholesterol 
      (LDL-c) level (0.10 mol/L, 95%CI: 0.09-0.17), and lowered triglyceride (TG) level 
      (0.05 mmol/L, 95%CI: 0.01-0.09). The odds of experiencing a hypoglycemic event in 
      pioglitazone-treated arms was significantly higher than comparator treatments 
      (RR=1.57, 95% CI 1.12-2.20, p<0.001). The case was the same with edema (RR=2.42, 
      95% CI 1.67-3.50, p<0.001). CONCLUSIONS: Our study implied that in patients with 
      type 2 DM whose control is inadequate on insulin therapy, the additional 
      pioglitazone could significantly improve glucose metabolism and might have a 
      positive effect on important components of the lipid profile, which may have 
      important implications in reducing the risk of cardiovascular disease, a major 
      long-term complication in type 2 diabetes mellitus. Besides, the adverse events 
      (AEs) were well tolerated.
CI  - Copyright (c) 2010. Published by Elsevier B.V.
FAU - Tan, Aihua
AU  - Tan A
AD  - Guangxi Medical University, Nanning, Guangxi, PR China.
FAU - Cao, Yunfei
AU  - Cao Y
FAU - Xia, Ning
AU  - Xia N
FAU - Mo, Zengnan
AU  - Mo Z
FAU - Gao, Feng
AU  - Gao F
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PL  - Netherlands
TA  - Eur J Intern Med
JT  - European journal of internal medicine
JID - 9003220
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Thiazolidinediones)
RN  - X4OV71U42S (Pioglitazone)
SB  - IM
MH  - Cardiovascular Diseases/epidemiology
MH  - Diabetes Mellitus, Type 2/*drug therapy/epidemiology
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Hypoglycemic Agents/*administration & dosage/adverse effects
MH  - Insulin/*administration & dosage/adverse effects
MH  - Pioglitazone
MH  - Risk Factors
MH  - Thiazolidinediones/*administration & dosage/adverse effects
EDAT- 2010/09/08 06:00
MHDA- 2010/12/31 06:00
CRDT- 2010/09/07 06:00
PHST- 2009/12/07 00:00 [received]
PHST- 2010/03/08 00:00 [revised]
PHST- 2010/03/30 00:00 [accepted]
PHST- 2010/09/07 06:00 [entrez]
PHST- 2010/09/08 06:00 [pubmed]
PHST- 2010/12/31 06:00 [medline]
AID - S0953-6205(10)00061-0 [pii]
AID - 10.1016/j.ejim.2010.03.018 [doi]
PST - ppublish
SO  - Eur J Intern Med. 2010 Oct;21(5):398-403. doi: 10.1016/j.ejim.2010.03.018.