Glitazone treatment of type 2 diabetes mellitus]

Glitazones (thiazolidinediones) represent a new class of hypoglycaemic medication. We hereby report the clinical effects we have observed of such treatment.Medical records of 33 patients (24 men) with type 2 diabetes (mean age 53 years, mean HbA1c 9.0%, mean BMI 32.4 kg/m2) were reviewed. The patients were followed regularly at a diabetic out-patient clinic between 2001 and 2005. They had been treated with either pioglitazone 15-45 mg (19 patients) or rosiglitazone 4-8 mg (14 patients) for > or = 6 months. Body weight, HbA1c, fasting plasma glucose, lipids, liver transaminases, haemoglobin and creatinine were recorded every 6 months.Glitazone treatment was associated with significant reductions in HbA1c and fasting plasma glucose. HbA1c was reduced with 1.2% after 6 months, 1.3% after 12, 2.3 after 18 and 1.5% after 24 months. Fasting plasma glucose was reduced with 2.8 mmol/L after 12 months, 4.5 mmol/L after 18 and 3.8 mmol/L after 24 months. There was a significant increase in HDL-cholesterol (0.1 mmol/L after 6 months). A statistically significant increase in weight (2.0 +/- 3.6 kg at 6 months and 3.6 +/-4.6 kg at 12 months) was found with a statistically significant negative correlation between the increase in weight and the reduction in HbA1c after 6 months of treatment (r = -0.625, n = 29, p < 0.001). Three patients developed peripheral oedema and three patients were withdrawn from treatment.Glitazone-treatment in overweight patients with poorly controlled type 2 diabetes mellitus significantly lowered HbA1c and fasting plasma glucose and raised HDL-cholesterol, but was associated with significant weight gain.