Successful switch from insulin therapy to treatment with pioglitazone in type 2 diabetes patients with residual β-cell function: results from the PioSwitch Study

Aim:  Insulin treatment is considered to be the final option for patients with progressive type 2 diabetes. This study investigated, whether reconverting type 2 patients from insulin treatment to oral treatment using pioglitazone is possible without deterioration of blood glucose control. Methods: ...

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Published in:Diabetes, obesity & metabolism obesity & metabolism, 2009-05, Vol.11 (5), p.464-471
Main Authors: Hohberg, C., Pfützner, A., Forst, T., Lübben, G., Karagiannis, E., Borchert, M., Schöndorf, T.
Format: Article
Language:English
Subjects:
Adult
Aged
Biomarkers - blood
Blood Glucose - metabolism
Body Mass Index
Diabetes Mellitus, Type 2 - drug therapy
Female
Humans
Hypoglycemic Agents - therapeutic use
Insulin - therapeutic use
insulin therapy
Male
Middle Aged
Pilot Projects
pioglitazone
Prospective Studies
Sulfonylurea Compounds
therapy switch
Thiazolidinediones
Treatment Outcome
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Summary:Aim:  Insulin treatment is considered to be the final option for patients with progressive type 2 diabetes. This study investigated, whether reconverting type 2 patients from insulin treatment to oral treatment using pioglitazone is possible without deterioration of blood glucose control. Methods:  The PioSwitch study was a prospective, open label, proof of concept study. Thiazolidinedione‐naïve patients with residual β‐cell function were switched from an existing insulin therapy to treatment with pioglitazone and glimepiride for 6 months. Efficacy was assessed by laboratory parameters and scores for evaluation of metabolic control, β‐cell function, insulin resistance and cardiovascular risk. Results:  In total, 98 patients [66 men, 32 women, age (mean ± s.d.): 59 ± 9 years; disease duration: 5.6 ± 3.6 years; Hemoglobin A1c (HbA1c): 6.9 ± 0.8%; body mass index (BMI): 33.9 ± 5.2 kg/m2, initial daily insulin therapy dose: 0.36 ± 0.3 U/kg body weight] out of 117 screened patients were treated. During the observation period, 23 patients were prematurely terminated because of an increase in HbA1c from baseline > 0.5% or other reasons. In 75 patients (76%), no deterioration of glucose metabolism occurred and additional improvements were seen in the majority of the observation parameters [baseline vs. endpoint; HbA1c: 6.79 ± 0.74%/6.66 ± 0.69% (p 
ISSN:1462-8902
1463-1326
DOI:10.1111/j.1463-1326.2008.00975.x