Low- dose Pioglitazone improves NAFLD in type 2 diabetes: Study

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-07-29T09:30:03+05:30 | Updated On 29 July 2021 10:24 AM IST

Complete 1-year treatment with low- dosage pioglitazone shows significant improvement in non-alcoholic fatty liver disease independent of glycaemic control level, suggests a study published in the Diabetes Research and Clinical Practice.

Non-Alcoholic Fatty Liver Disease (NAFLD) and type 2 diabetes have similar pathophysiological mechanisms and potential treatment methods.

A study was performed by Pepa G et. al to assess the effects of 1-year treatment with pioglitazone or sulphonylureas on indirect indices of NAFLD in patients with type-2 diabetes and the role of insulin resistance as well as glucotoxicity in determining these effects.

The researchers selected a total of 195 type-2 diabetes patients belonging to the age group of 50-75 years, with inadequately controlled blood sugar levels and receiving metformin 2 g/day. All the participants were randomly allocated to either add-on pioglitazone (n=98) or sulphonylureas (n=97) within the TOSCA.IT trial.

Plasma insulin, glucose, and liver enzymes were measured at baseline and after 1-year. Indirect indices of NAFLD (Liver Fat Equation [LFE], Hepatic Steatosis Index [HSI], and Index of NASH [ION]), and insulin resistance (HOMA-IR, Visceral Adiposity Index [VAI] and adipose tissue Insulin Resistance [ADIPO-IR]) were calculated.

The findings of the study are as follows:

· NAFLD indices improved after pioglitazone, but not after sulphonylureas; Indices of insulin resistance decreased after pioglitazone, but not after sulphonylureas.

· Changes in NAFLD indices were similar with different doses of pioglitazone (15, 30, or 45 mg/day), and were independent of blood glucose control level.

The researchers concluded that one-year treatment with pioglitazone even at low dosage drastically improved liver steatosis, inflammation, systemic and adipose tissue insulin resistance in patients with type-2 diabetes. Also, the beneficial effects of pioglitazone on NAFLD was independent of blood glucose control level.

Reference:

A study titled, "Pioglitazone even at low dosage improves NAFLD in type 2 diabetes: clinical and pathophysiological insights from a subgroup of the TOSCA.IT randomized trial" by Pepa G et. al published in the Diabetes Research and Clinical Practice

DOI: https://doi.org/10.1016/j.diabres.2021.108984

non-alcoholic fatty liver diseasetype-2 diabetespioglitazonediabetes Research and Clinical PracticeBlood sugar control

Source : Diabetes Research and Clinical Practice

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751