Effect of pioglitazone on arteriosclerosis in comparison with that of glibenclamide

Background: Pioglitazone is an insulin-sensitizing agent that has been reported to have anti-arteriosclerotic effects. Objective: To investigate the anti-arteriosclerotic effects of pioglitazone in patients with diabetes mellitus using pulse wave velocity (PWV) as an index of efficacy. Methods: Twenty-seven patients with type 2 diabetes mellitus were randomly assigned to two groups, and pioglitazone (n = 13) or glibenclamide (n = 14) was administered for 6 months. The TG, TC, LDL-C, and HDL-C, FPG, HbA1c, IRI levels, HOMA-IR, and ba-PWV data were examined before and after administration of each agent. Results: FPG and HbA1c were significantly improved in both the groups after treatment, but IRI, HOMA-IR and were improved only in the PIO group. The percent change of ba-PWV from the baseline after treatment in the PIO group improved significantly than that in the GC group (-6.3 +/- 5.6% versus 0.8 +/- 15.7%). Conclusions: The findings in this study suggested that pioglitazone has anti-arteriosclerotic effects. We concluded that drugs for the treatment of diabetes mellitus should be selected taking into consideration such endpoints as blood sugar control, and also the risk of complications such as cardiovascular events in the future. (c) 2004 Elsevier Ireland Ltd. All rights reserved.