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How well does pioglitazone, an “insulin-sensitizing” thiazolidinedione, slow progression of carotid intima-media thickness (CIMT), a marker of coronary atherosclerosis, in patients with type 2 diabetes? To find out, researchers conducted a manufacturer-funded, double-blind, randomized trial comparing pioglitazone (15–45 mg/day) with glimepiride (1–4 mg/day), a sulfonylurea commonly used to control diabetes. Participants were 462 type 2 diabetes patients (age range, 45–85; mean age, 60; 71% with hypertension; mean HbA1c value, 7.4%) seen at 28 Chicago-area clinical sites from October 2003 to May 2006. Upon enrollment, the majority of subjects were taking oral diabetes medications and statins.
About 70% of each group completed the study. From …