Efficacy and safety of pioglitazone versus metformin in patients with type 2 diabetes mellitus: a double-blind, randomized trial. J Clin Endocrinol Metab

Pioglitazone increases the insulin sensitivity of peripheral tissues andmayprovide analternative first-line treatment for type 2 diabetes. This study compared metabolic control in drug-naive type 2 diabetes patients given either pioglitazone or metformin. Eleven hundred and ninety-nine patients with poorly controlled type 2 diabetes mellitus [glycosylated he-moglobin (HbA1c), 7.5–11%; normal, 4.3–6.1%] were random-ized to receive either pioglitazone (<45 mg/d) or metformin (<850 mg, three times daily). HbA1c, fasting plasma glucose (FPG), insulin levels, total cholesterol (TC), high density li-poprotein cholesterol (HDL-C), low density lipoprotein cho-lesterol, triglycerides, free fatty acids, and urinary albumin/ creatinine ratio were measured. Mean HbA1c decreased in both treatment groups from baseline to wk 52 (1.4 % and 1.5%). Significantly greater mean reductions in FPG wer