[Prevention and treatment for development and progression of diabetic macroangiopathy with pioglitazone and

Related Experiment Video

Updated: Jul 19, 2026

Studying Pancreatic Cancer Stem Cell Characteristics for Developing New Treatment Strategies
07:29

Studying Pancreatic Cancer Stem Cell Characteristics for Developing New Treatment Strategies

Published on: June 20, 2015

Hiroshi Tamura1, Hiroshi Mokuno, Hiroyuki Daita

  • 1Division of Cardiology, Department of Internal Medicine, Juntendo University School of Medicine.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|November 8, 2006
PubMed

Insights

Insulin resistance drives diabetic macroangiopathy, a major cause of mortality in diabetes mellitus. Agents improving insulin resistance, like metformin and pioglitazone, show promise in preventing this condition.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Metabolic Diseases

Background:

  • Diabetic macroangiopathy is a leading cause of mortality in diabetes mellitus.
  • Current glycemic control strategies often fail to adequately prevent diabetic macroangiopathy.
  • Insulin resistance is increasingly recognized as a key factor in the pathogenesis of diabetic macroangiopathy.

Purpose of the Study:

  • To evaluate the role of insulin resistance in diabetic macroangiopathy.
  • To assess the potential of insulin-sensitizing agents in preventing diabetic macroangiopathy.
  • To review clinical evidence supporting the use of metformin and pioglitazone for macrovascular complication prevention.

Main Methods:

  • Review of clinical studies and pathogenetic mechanisms.
  • Analysis of data from landmark trials like UKPDS 34 and PROactive.
  • Focus on agents targeting insulin resistance.

Main Results:

  • Insulin resistance significantly contributes to the development of atherosclerosis in diabetic patients.
  • Metformin and pioglitazone improve glucose and lipid metabolism by enhancing insulin sensitivity.
  • These agents possess anti-atherogenic properties, potentially preventing macrovascular complications.

Conclusions:

  • Targeting insulin resistance is a critical strategy for managing diabetic macroangiopathy.
  • Metformin and pioglitazone demonstrate preventive effects against diabetic macroangiopathy.
  • Further research and clinical application of insulin-sensitizing agents are warranted for improved patient outcomes.

Related Concept Videos

Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood glucose levels...
Diabetic Retinopathy01:27

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a significant...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...