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Prevention of diabetes with pioglitazone in ACT NOW: physiologic correlates. (Articolo in rivista)

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Prevention of diabetes with pioglitazone in ACT NOW: physiologic correlates. (Articolo in rivista) (literal)

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Defronzo RA, Tripathy D, Schwenke DC, Banerji M, Bray GA, Buchanan TA, Clement SC, Gastaldelli A, Henry RR, Kitabchi AE, Mudaliar S, Ratner RE, Stentz FB, Musi N, Reaven PD; ACT NOW Study. (2013)
Prevention of diabetes with pioglitazone in ACT NOW: physiologic correlates.
in Diabetes (N.Y.N.Y.)
(literal)

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Defronzo RA, Tripathy D, Schwenke DC, Banerji M, Bray GA, Buchanan TA, Clement SC, Gastaldelli A, Henry RR, Kitabchi AE, Mudaliar S, Ratner RE, Stentz FB, Musi N, Reaven PD; ACT NOW Study. (literal)

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[ 1,2,14 ] Texas Diabet Inst, San Antonio, TX USA [ 1,2,8,14 ] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA [ 3,15 ] Phoenix VA Hlth Care Syst, Phoenix, AZ USA [3] Arizona State Univ, Coll Nursing & Hlth Innovat, Phoenix, AZ USA [ 4 ] SUNY Hlth Sci Ctr, Brooklyn, NY USA [ 5 ] Louisiana State Univ, Pennington Biomed Res Ctr, Baton Rouge, LA 70808 USA [ 6 ] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA [ 7 ] Georgetown Univ, Div Endocrinol & Metab, Washington, DC USA [ 8 ] CNR, Inst Clin Physiol, Cardiometab Risk Unit, I-56100 Pisa, Italy [ 9,11 ] VA San Diego Healthcare Syst, San Diego, CA USA [ 9,11 ] Univ Calif San Diego, La Jolla, CA 92093 USA [ 10,13 ] Univ Tennessee, Div Endocrinol Diabet & Metab, Memphis, TN USA [ 12 ] Medstar Res Inst, Hyattsville, MD USA (literal)

Titolo

Prevention of diabetes with pioglitazone in ACT NOW: physiologic correlates. (literal)

Abstract

We examined the metabolic characteristics that attend the development of type 2 diabetes (T2DM) in 441 impaired glucose tolerance (IGT) subjects who participated in the ACT NOW Study and had complete end-of-study metabolic measurements. Subjects were randomized to receive pioglitazone (PGZ; 45 mg/day) or placebo and were observed for a median of 2.4 years. Indices of insulin sensitivity (Matsuda index [MI]), insulin secretion (IS)/insulin resistance (IR; ?I0-120/?G0-120, ?IS rate [ISR]0-120/?G0-120), and ?-cell function (?I/?G × MI and ?ISR/?G × MI) were calculated from plasma glucose, insulin, and C-peptide concentrations during oral glucose tolerance tests at baseline and study end. Diabetes developed in 45 placebo-treated vs. 15 PGZ-treated subjects (odds ratio [OR] 0.28 [95% CI 0.15-0.49]; P < 0.0001); 48% of PGZ-treated subjects reverted to normal glucose tolerance (NGT) versus 28% of placebo-treated subjects (P < 0.005). Higher final glucose tolerance status (NGT > IGT > T2DM) was associated with improvements in insulin sensitivity (OR 0.61 [95% CI 0.54-0.80]), IS (OR 0.61 [95% CI 0.50-0.75]), and ?-cell function (ln IS/IR index and ln ISR/IR index) (OR 0.26 [95% CI 0.19-0.37]; all P < 0.0001). Of the factors measured, improved ?-cell function was most closely associated with final glucose tolerance status. (literal)

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