Related Experiment Video
Updated: Jul 24, 2025
11:06
Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
4.5K
[Rediscovery of pioglitazone]
Bence Pokoly1,2, Anikó Somogyi3
11 Országos Mozgásszervi Intézet - Országos Reumatológiai és Fizioterápiás Intézet Budapest, Frankel Leó út 25-29. Magyarország.
Orvosi Hetilap
|July 2, 2023
Summary
Pioglitazone, a thiazolidinedione, significantly reduced cardiovascular events in type 2 diabetes patients and may be useful in personalized treatment plans. This review summarizes its benefits and risks.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Pharmacology
Context:
- The landscape of type 2 diabetes management has evolved with new drug classes like GLP1 receptor agonists and SGLT2 inhibitors.
- Thiazolidinediones, specifically pioglitazone, have seen a decline in use despite early evidence of cardiovascular benefit.
Purpose:
- To review the accumulated evidence on pioglitazone over recent years.
- To provide an overview of pioglitazone's molecular, cellular, and pathophysiological effects.
- To discuss the cardiovascular, metabolic, and other benefits, alongside potential side effects of pioglitazone.
Summary:
- Pioglitazone was the first drug to significantly reduce the 3-point MACE (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke) in a randomized trial (PROactive, 2005).
- This review consolidates key evidence on pioglitazone, detailing its mechanisms, benefits, and confirmed side effects.
- The paper suggests pioglitazone's potential role in personalized, combination therapy for carefully selected type 2 diabetes patients.
Impact:
- Re-evaluates pioglitazone's established role in managing cardiovascular complications in type 2 diabetes.
- Highlights the potential for pioglitazone in contemporary, personalized treatment strategies for type 2 diabetes.
- Provides a comprehensive summary of evidence to guide clinical decision-making regarding pioglitazone use.
Related Concept Videos
01:26Oral Hypoglycemic Agents: Biguanides and Glitazones
238
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...
238
01:23Dipeptidyl Peptidase 4 Inhibitors
214
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...
214
01:24Glucagon-like Receptor Agonists
365
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
365
01:06Oral Hypoglycemic Agents: Glinides
189
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
189
01:19Oral Hypoglycemic Agents: α-Glucosidase Inhibitors
208
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...
Acarbose and miglitol are...
208
01:17Oral Hypoglycemic Agents: Sulfonylureas
245
Sulfonylureas are oral hypoglycemic agents utilized in treating type 2 diabetes. They are characterized by their unique sulfonylurea chemical structure. The family of sulfonylureas is divided into generations. First-generation sulfonylureas, including tolbutamide (Orinase), chlorpropamide (Diabinese), and tolazamide (Tolinase), trigger insulin release from pancreatic β cells and enhance peripheral tissues' insulin sensitivity. The second-generation members, such as glipizide...
245