Lower dose of insulin-sensitizing drug benefits patients with Type 2 diabetes (Cheap pioglitazone works best w/fewest side effects at below normal doses, while still reducing insulin need)

Medical Xpress / University at Buffalo / Diabetes, Obesity and Metabolism ^ | Apr. 1, 2022 | Ellen Goldbaum / J. David Spence et al

[ConservativeMind]

An insulin-sensitizing drug can benefit patients with insulin resistance at lower doses than has typically been prescribed, according to a study

The study shows that low doses of pioglitazone used to treat diabetes in patients with insulin resistance may be preferable.

Pioglitazone is a potent insulin-sensitizing drug with anti-atherosclerotic properties, but adverse effects of weight gain and edema have limited its use.

Dandona says pioglitazone is currently used to treat patients with Type 2 diabetes.

"Unfortunately, many clinicians are reluctant to use pioglitazone because of adverse effects, particularly weight gain and edema, and the drug is seldom prescribed by neurologists in their stroke patients," he says.

Dandona says he instigated the reanalysis of the IRIS study because he has been prescribing pioglitazone over the past decade at a low dose of 15 milligrams with excellent results of glycemic control without the side effects of weight gain and edema.

"Since most of the patients in the study were treated with the high dose of 45 milligrams daily, which has frequent side effects of weight gain and edema, it was important to reanalyze the data to focus on the effects of the two lower doses (15 and 30 milligrams daily) of the drug, he says.

"The IRIS study reanalysis clearly demonstrates that while the two lower doses provide cardiovascular protection similar to that of the higher dose, the side effects of edema and weight gain are significantly lower.

"A more frequent use of this drug at lower doses in diabetes and prediabetes by physicians would contribute to significant improvements in glycemic control and cardiovascular complications," Dandona adds.

Furthermore, since pioglitazone is a generic drug, it is inexpensive compared to insulin.

"Hence, pioglitazone must be used prior to insulin, especially since subcutaneously injected insulin has no protective effect on cardiovascular complications," Dandona says.

[ConservativeMind]

This can greatly reduce the need for insulin, while helping as an anti-atherosclerotic medicine

Goodrx shows this to be under $10 a prescription.

[ConservativeMind]

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[airedale]

I used to take this years ago and they took me off of it suddenly due to some study and potential side effects. I can’t remember the details. I do remember the doctor considered it serious.

[nevadapatriot]

Actos

[Dogbert41]

I know the cost difference is serious! My two injectables alone cost about $120 a month. When I retire, that will be hard.

[airedale]

NPH and R here but I’m on Senior Advantage program so its cheap.

[sauropod]

Bkmk