Trial reportThe American journal of medicine2004
Addition of pioglitazone or bedtime insulin to maximal doses of sulfonylurea and metformin in type 2 diabetes patients with poor glucose control: a prospective, randomized trial.
Trial report in The American journal of medicine, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Thiazolidinediones for people with chronic kidney disease and diabetes.The Cochrane database of systematic reviews · 2025Pooled it
- Insulin and glucose-lowering agents for treating people with diabetes and chronic kidney disease.The Cochrane database of systematic reviews · 2018Pooled it
- Choice of therapy in patients with type 2 diabetes inadequately controlled with metformin and a sulphonylurea: a systematic review and mixed-treatment comparison meta-analysis.Open medicine : a peer-reviewed, independent, open-access journal · 2012Pooled it
- A meta-analysis of the effect of thiazolidinediones on blood pressure.Journal of clinical hypertension (Greenwich, Conn.) · 2006Pooled it
- Trial
- Safety and effectiveness of rosiglitazone in type 2 diabetes patients with nonalcoholic Fatty liver disease.Journal of the Formosan Medical Association = Taiwan yi zhi · 2006Trial
- Thiazolidinediones and Edema: Recent Advances in the Pathogenesis of Thiazolidinediones-Induced Renal Sodium Retention.PPAR research · 2015Review
- Insulin therapy in people with type 2 diabetes: opportunities and challenges?Diabetes care · 2014Article
- Achieving glycaemic targets with basal insulin in T2DM by individualizing treatment.Nature reviews. Endocrinology · 2014Review
- The future of thiazolidinedione therapy in the management of type 2 diabetes mellitus.Current diabetes reports · 2013Review
- Therapeutic modalities in diabetic nephropathy: standard and emerging approaches.Journal of general internal medicine · 2012Review
- Comparison of hemoglobin A1c goal achievement with the addition of pioglitazone to maximal/highest tolerated doses of sulfonylurea and metformin combination therapy.Journal of drug assessment · 2012Article
- Pioglitazone for the treatment of type 2 diabetes in patients inadequately controlled on insulin.Diabetes, metabolic syndrome and obesity : targets and therapy · 2010Article
- Cost-effectiveness of pioglitazone in type 2 diabetes patients with a history of macrovascular disease: a German perspective.Cost effectiveness and resource allocation : C/E · 2009Article
- Patient factors associated with hemoglobin A1C change with pioglitazone as adjunctive therapy in type 2 Diabetes Mellitus.Pharmacy practice · 2008Article
- Peroxisome proliferator-activated receptors in diabetic nephropathy.PPAR research · 2008Article
- Insulin versus an oral antidiabetic agent as add-on therapy in type 2 diabetes after failure of an oral antidiabetic regimen: a meta-analysis.Open medicine : a peer-reviewed, independent, open-access journal · 2008Article
- Pioglitazone and sulfonylureas: effectively treating type 2 diabetes.International journal of clinical practice. Supplement · 2007Review
- A review of pioglitazone HCL and glimepiride in the treatment of type 2 diabetes.Vascular health and risk management · 2007Review
- Drug Interactions of Clinical Importance with Antihyperglycaemic Agents : An Update.Drug safety · 2005Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo compare the efficacy of adding pioglitazone or bedtime isophane (NPH) insulin to maximal doses of metformin and an insulin secretagogue in patients with poor glucose control.
methodsWe conducted a nonblinded, open-label, randomized controlled trial involving 62 patients with type 2 diabetes and glycosylated hemoglobin (HbA1C) levels >8.0%. Patients received either pioglitazone or bedtime NPH insulin in addition to their usual diabetes medication for 16 weeks. Outcome measurements of glycemic control, hypoglycemia, blood pressure, lipid levels, microalbuminuria, and quality of life were assessed at baseline and at 16 weeks.
resultsHbA1C levels were lowered to a similar degree in each treatment arm (pioglitazone: -1.9% +/- 1.5%; insulin: -2.3% +/- 1.5%; P = 0.32), but hypoglycemia was less common among patients who received pioglitazone than those who received insulin (37% [11/30] vs. 68% [19/28], P=0.02). Pioglitazone, but not insulin, resulted in an increase in high-density lipoprotein (HDL) cholesterol levels. Both treatments had similar effects on weight, other lipid values, blood pressure, and urine microalbumin levels.
conclusionAdding pioglitazone or bedtime insulin for 16 weeks improved glycemic control in type 2 diabetic patients with secondary oral agent failure. Pioglitazone was associated with less hypoglycemia and improved HDL cholesterol levels.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.