Effect of pioglitazone on the drivers of cardiovascular risk in type 2 diabetes


  • Disclosure The author has received honoraria for consultancy, advisory board attendance and speaker fees from several pharmaceutical companies.

Prof. Richard Donnelly,
University of Nottingham Medical School,
Derby City General Hospital,
Uttoxeter Road,
Derby DE22 3DT, UK
Tel.: + 44 1332 724618
Fax: + 44 1332 724619
Email: richard.donnelly@nottingham.ac.uk


The prevalence of type 2 diabetes and its associated mortality and morbidity are continuing to increase across the world. People with type 2 diabetes typically have a cluster of risk factors for cardiovascular disease, including hyperglycaemia, hypertension and lipid abnormalities, which contribute to the high cardiovascular morbidity and mortality in these patients. Targets for glycosylated haemoglobin, lipids and blood pressure are becoming more stringent, and most patients will require multiple therapies to maximally reduce cardiovascular risk. In a large randomised, controlled, long-term cardiovascular outcomes study pioglitazone showed durable glycaemic control, a powerful insulin-sparing effect and changes in the lipid profile associated with reduced cardiovascular risk. This article reviews these metabolic findings in the context of previous randomised, controlled studies for pioglitazone and discusses whether the integration of this agent into the treatment regimen of appropriate patient groups has the potential to improve cardiovascular outcomes in type 2 diabetes.