Brand Names:
Actos, ACTOplus met(combination)
What is it?
This drug works on something called PPAR gamma to turn on a gene that increases the effect of insulin on the cell. This lowers blood sugar for people with Type 2 Diabetes.
What’s In It For Me?
Pioglitazone can lower your blood sugar, which can help with preventing problems with your eyes, kidneys, and heart.
The Good
Unlike it’s cousin rosiglitazone, pioglitazone helps to lower triglycerides and increase your good cholesterol (HDL), while helping to lower your blood sugars.
The Bad
This drug is not as effective as other options at lowering the blood sugar and the A1C. As you might expect, turning on a gene has more than one effect. Rosiglitazone causes fluid to be retained by the body. This can cause annoying swelling in the legs for some people. This fluid retention is an even bigger problem for people with Heart Failure. The other common problem is that it can cause weight gain. This is not just fluid weight, you actually may gain some fat, which is not on most peoples list of things to do.
The Controversial
Pioglitazone’s cousin Rosiglitazone has been accused of increasing heart attacks. Studies so far have not shown that pioglitzone has any risk of heart attacks.
Fact Boxes
|
Drug |
average A1c decrease |
average blood sugar decrease |
Causes hypoglycemia? |
|---|---|---|---|
|
rosiglitazone and Pioglitazone |
0.6 to 0.8 |
30 to 50 |
no |
|
0.8 to 1.5 |
30 to 50 |
no |
|
|
1 to 2 |
50 to 70 |
yes |
|
|
sitagliptin |
0.6 to 0.8 |
20 to 30 |
not much |
For The Cynic
Some benefit in decreasing your sugar levels, not the greatest option out there.
The Cost
Looks like Pioglitazone is more expensive than Rosiglitazone now that the news has claimed that Rosiglitazone increases risk of heart attacks.
With the modest benefit, annoying side effects and high cost, pioglitazone is near the bottom of our list for Diabetes drugs.
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