VIDEO: Pioglitazone offers ‘cost-effective’ option for reducing diabetes risk

Pioglitazone offers patients with prediabetes and/or patients who have a history of prior stroke a cost-effective therapy option to reduce the risk for type 2 diabetes, according to Alvin C. Powers, MD, director of the division of diabetes, endocrinology and metabolism at Vanderbilt University School of Medicine and president of the American Diabetes Association.

In this video, Powers discusses the results of a study presented at the American Diabetes Association Scientific Sessions.

“Now that pioglitazone is now generic, [it] is a very cost effective medication [that] will both reduce the progression to type 2 diabetes and [it] also has been shown to reduce atherosclerotic events in a prior trial,” he told Endocrine Today.

The study Powers discusses was conducted by Silvio E. Inzucchi, MD, director of the Yale Diabetes Center, and colleagues, who evaluated data from the Insulin Resistance after Stroke (IRIS) trial. The trial assessed 3,876 individuals without diabetes who had insulin resistance (defined by homeostasis model of assessment of insulin resistance [HOMA-IR] of more than 3) and who had a recent stroke or heart attack.

Participants were randomly assigned pioglitazone (Actos, Takeda; n = 1,939) or placebo (n = 1,937) to determine the effect of pioglitazone on glycemic parameters and diabetes prevention.

HOMA-IR decreased to 4.1 in the pioglitazone group and increased to 5.7 in the placebo group after 1 year (P < .0001); fasting plasma glucose levels were 95.1 mg/dL in the pioglitazone group and 99.7 mg/dL in the placebo group (P < .0001).

Diabetes developed in 3.8% of the pioglitazone group compared with 7.7% of the placebo group during 4.8 years (HR = 0.48; 95% CI, 0.33-0.69).

Participants who had prediabetes (FPG 100 mg/dL or HbA1c 7.5%) and those who had the worst insulin resistance (HOMA-IR 4.6) had the greatest risk reduction for diabetes.