Diabetes Mellitus Clinical Trial
Official title:
Double-blind, Randomized, Multicenter, Parallel-Group Study to Evaluate the Effects of Pioglitazone on Metabolic Syndrome in Patients With Type 2 Diabetes Treated With Metformin
The purpose of this study was to determine the efficacy of pioglitazone taken with metformin on high-density lipoprotein cholesterol in subjects with Type 2 Diabetes.
Diabetes is none of the most common, chronic diseases worldwide and affects nearly 200
million people. It is the fourth or fifth leading cause of death in developed countries, and
it is expected that diabetes will reach epidemic proportions, affecting 333 million people
globally by 2025.
The metabolic syndrome is a cluster of the most dangerous cardiovascular risk factors and
includes diabetes and pre-diabetes in addition to abdominal obesity, low high-density
lipoprotein cholesterol, high triglycerides and hypertension. It is estimated that around a
quarter of the world's adult population has metabolic syndrome, and are twice as likely to
die and three times as likely to have a heart attack or stroke when compared to people
without the syndrome. In addition, non-diabetic people with metabolic syndrome have a
fivefold greater risk of developing type 2 diabetes. The clustering of cardiovascular risk
factors that typifies the metabolic syndrome is now considered the driving force for a
cardiovascular disease epidemic.
Metabolic syndrome has been recently defined by a Consensus Conference of the International
Diabetes Federation as a cluster of clinical and laboratory signs characterized by the
presence of abnormal deposition of fat tissue in the abdomen and visceral districts, and at
least two other clinical and laboratory abnormalities, including altered glucose metabolism
or type 2 diabetes and decreased levels of high-density lipoprotein cholesterol. One of the
underlying pathophysiological mechanisms of metabolic syndrome is insulin resistance,
characterized by an increased glucose output from the liver, and reduced glucose uptake in
the muscle and adipose tissue cells. Drugs whose mechanism of action consists of increasing
insulin sensitivity in the target tissues are able to reduce the clinical manifestations and
consequences of metabolic syndrome.
While each individual component of metabolic syndrome confers an increased risk of
cardiovascular-related complications or death, this risk is more pronounced when the
syndrome itself is present. The more components of metabolic syndrome are evident, the
higher is the cardiovascular mortality rate.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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