Pioglitazone in prediabetes

Pioglitazone is known to improve insulin sensitivity, glycaemic control, hypertension and dyslipidaemia in people with T2DM (1).

Pioglitazone:

• decreases fasting and postprandial plasma glucose levels by improving the sensitivity of hepatic and peripheral (muscle) tissue to insulin

A systematic review concluded that "Pioglitazone reduced or delayed the development of T2DM in people at increased risk of T2DM compared with placebo (low-certainty evidence) and compared with no intervention (moderate-certainty evidence). .. unclear whether the effect of pioglitazone is sustained once discontinued. Pioglitazone compared with metformin neither showed advantage nor disadvantage regarding the development of T2DM in people at increased risk (low-certainty evidence)."

Reference:

• Schernthaner G et al. Do we still need pioglitazone for the treatment of type 2 diabetes? A risk-benefit critique in 2013. Diabetes Care 2013;36 Suppl 2:S155-61. [PMID: 23882041]
• Ipsen EO et al. Pioglitazone for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus. Cochrane Database of Systematic Reviews 2020, Issue 11. Art. No.: CD013516. DOI: 10.1002/14651858.CD013516.pub2.