Pioglitazone Reduces Macrovascular Events in Type 2 Diabetes

Thiazolidinediones cause metabolic changes that might reduce risk for macrovascular complications in patients with type 2 diabetes. In this international study, funded and partially conducted by the manufacturer of the thiazolidinedione pioglitazone, researchers randomized 5238 patients (mean age, 62; 99% white) with type 2 diabetes (hemoglobin A_1c >6.5% despite treatment) and advanced macrovascular disease to receive placebo or pioglitazone (maximum, 45 mg daily). All patients received other oral hypoglycemic agents and insulin as needed to reduce HbA_1c below 6.5%, as well as optimal antihypertensive, antiplatelet, and antihyperlipidemic therapies.

During a mean follow-up of 35 months, the median decrease in HbA_1c was significantly greater …