Evidence map›Paper›PMID 19277602›Full record

ArticleDiabetologia2009

Pioglitazone does not enhance the effectiveness of lifestyle modification in preventing conversion of impaired glucose tolerance to diabetes in Asian Indians: results of the Indian Diabetes Prevention Programme-2 (IDPP-2).

A Ramachandran, C Snehalatha, S Mary, S Selvam, C K S Kumar, A C Seeli, A S Shetty

2 registry-linked trialsOpen access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in Diabetologia, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 47 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 6 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT00276497 phase1completednot on this map

Role of Pioglitazone in Preventing Diabetes

TypeinterventionalSponsorM.V. Hospital for DiabetesRan2003 to 2008ConditionsDiabetesArmsPioglitazone
NCT01570946 nacompletednot on this mapstarted 2012, after this paper: background citation

A Pragmatic and Scalable Strategy Using Mobile Technology to Promote Sustained Lifestyle Changes to Prevent Type 2 Diabetes in India and the UK

TypeinterventionalSponsorIndia Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes HospitalsRan2012 to 2015Enrolled1,171ConditionsPrediabetic StateArmsLifestyle Modification
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 6 syntheses or guidelines pooled it, 106 citations in OpenAlex.

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  18. Prediabetes.Nature reviews. Disease primers · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

A RamachandranIndia Diabetes Research Foundation, Egmore, Chennai, India. ramachandran@vsnl.com
C Snehalatha
S Mary
S Selvam
C K S Kumar
A C Seeli
A S Shetty
India Diabetes Research Foundation · INDr. A. Ramachandran's Diabetes Hospitals · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisThe objective of this prevention programme was to study whether combining pioglitazone with lifestyle modification would enhance the efficacy of lifestyle modification in preventing type 2 diabetes in Asian Indians with impaired glucose tolerance.

methodsIn a community-based, placebo-controlled 3 year prospective study, 407 participants with impaired glucose tolerance (mean age 45.3 +/- 6.2 years, mean BMI 25.9 +/- 3.3 kg/m(2)) were sequentially grouped to receive either: lifestyle modification plus pioglitazone, 30 mg (n = 204) or lifestyle modification plus placebo (n = 203). The participants and investigators were blinded to the assignment. The primary outcome was development of diabetes.

resultsAt baseline, both groups had similar demographic, anthropometric and biochemical characteristics. At year 3, the response rate was 90.2%. The cumulative incidence of diabetes was 29.8% with pioglitazone and 31.6% with placebo (unadjusted HR 1.084 [95% CI 0.753-1.560], p = 0.665). Normoglycaemia was achieved in 40.9% and 32.3% of participants receiving pioglitazone and placebo, respectively (p = 0.109). In pioglitazone group, two deaths and two non-fatal hospitalisations occurred due to cardiac problems; in the placebo group there were two occurrences of cardiac disease. CONCLUSIONS/

interpretationDespite good adherence to lifestyle modification and drug therapy, no additional effect of pioglitazone was seen above that achieved with placebo. The effectiveness of the intervention in both groups was comparable with that of lifestyle modification alone, as reported from the Indian Diabetes Prevention Programme-1. The results are at variance with studies that showed significant relative risk reduction in conversion to diabetes with pioglitazone in Americans with IGT. An ethnicity-related difference in the action of pioglitazone in non-diabetic participants may be one explanation.

trial registrationClinicalTrials.gov NCT00276497

fundingThis study was funded by the India Diabetes Research Foundation.

Indexed as

Life StyleAdultAsian PeopleCombined Modality TherapyDiabetes Mellitus, Type 2FemaleGlucose IntoleranceHumansHypoglycemic AgentsMaleMiddle AgedModels, TheoreticalPioglitazoneProspective StudiesThiazolidinedionesHypoglycemic AgentsPioglitazoneThiazolidinediones

Identifiers

PMID19277602
OpenAlexW1968039145

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.