Evidence mapPaperPMID 12730556Full record

Trial reportStroke2003

Pioglitazone improves insulin sensitivity among nondiabetic patients with a recent transient ischemic attack or ischemic stroke.

Walter N Kernan, Silvio E Inzucchi, Catherine M Viscoli, Lawrence M Brass, Dawn M Bravata, Gerald I Shulman, James C McVeety, Ralph I Horwitz

Registry-linked trialAbstract readClinical TrialRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Stroke, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02765399 (The Effect of Liraglutide Treatment on Postprandial Chylomicron and VLDL Kinetics, Liver Fat and de Novo Lipogenesis - a Single-center Randomized Controlled Study), which is not on this map. Cited by 36 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02765399 phase4completedstarted 2015, after this paper: background citation

The Effect of Liraglutide Treatment on Postprandial Chylomicron and VLDL Kinetics, Liver Fat and de Novo Lipogenesis - a Single-center Randomized Controlled Study

Ran2015Enrolled23Registered outcomes21Posted comparisons42ConditionsType 2 DiabetesArmsliraglutide, Placebo
Open the trial in the graph
3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Mifepristone Improves Adipose Tissue Insulin Sensitivity in Insulin Resistant Individuals.The Journal of clinical endocrinology and metabolism · 2021
    Trial
  5. Trial
  6. Pioglitazone after Ischemic Stroke or Transient Ischemic Attack.The New England journal of medicine · 2016 · on this map
    Trial
  7. Trial
  8. Trial
  9. Trial
  10. Review
  11. Article
  12. Review
  13. Novel Cardiometabolic Medications in the Cardiovascular-Kidney-Metabolic Syndrome Era.The Journal of clinical endocrinology and metabolism · 2025 · on this map
    Review
  14. Article
  15. Article
  16. Review
  17. Observational
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Walter N KernanDepartment of Medicine, Yale University School of Medicine, PO Box 208025, New Haven, CT 06520-8025, USA. Walter.Kernan@Yale.Edu
Silvio E Inzucchi
Catherine M Viscoli
Lawrence M Brass
Dawn M Bravata
Gerald I Shulman
James C McVeety
Ralph I Horwitz

Funding

ZIPRASIDONE IN TOURETTES SYNDROME, OBSESSIVE COMPULSIVE &PERVASIVE DEV. DISORDERM01RR000125 · YALE UNIVERSITY · 1985 to 2005
$20.7M
NMR STUDIES OF GLYCOGEN METABOLISM IN HUMANSR01DK049230 · YALE UNIVERSITY · 1995 to 2004
$2.5M
NCRR NIH HHS M01RR00125NIDDK NIH HHS R01 DK-49230
6 · The paper itself

Abstract

background and purposeThe aim of this study was to determine the effectiveness of pioglitazone compared with placebo for improving insulin sensitivity among nondiabetic patients with a recent transient ischemic attack (TIA) or nondisabling ischemic stroke and impaired insulin sensitivity.

methodsEligible subjects were men and women >45 years of age who had no history of diabetes, fasting glucose <7.0 mmol/L, and impaired insulin sensitivity according to an index calculated from insulin and glucose blood levels obtained during an oral glucose tolerance test. Eligible subjects were randomized to pioglitazone 45 mg/d or placebo. After 3 months of therapy, the glucose tolerance test was repeated.

resultsBetween July 2000 and June 2001, we performed oral glucose tolerance tests on 75 patients with no history of diabetes, among whom 36 (50%) were found to have impaired insulin sensitivity and fasting glucose <7.0 mmol/L. Among these 36, 20 consented to the trial. Patients assigned to pioglitazone (n=10) and placebo (n=10) were similar in insulin sensitivity, age, obesity, and index event (stroke compared with TIA), but patients assigned to pioglitazone were less likely to be male (4 compared with 9). The mean proportional increase in insulin sensitivity was 62% among patients assigned to pioglitazone compared with a -1% decline among patients assigned to placebo (P=0.0006). Mean C-reactive protein concentration declined from 0.30 to 0.20 mg/L among patients assigned to pioglitazone and increased from 0.41 to 0.45 mg/L among patients assigned to placebo (P=0.06 for comparison of mean change).

conclusionsPioglitazone is effective for improving insulin sensitivity among patients with recent TIA or stroke and impaired insulin sensitivity.

Indexed as

Insulin ResistanceThiazolidinedionesAgedBlood GlucoseBrain IschemiaFemaleGlucose Tolerance TestHumansHypoglycemic AgentsInsulinIschemic Attack, TransientMalePatient CompliancePioglitazoneRisk FactorsStrokeBlood GlucoseHypoglycemic AgentsInsulinPioglitazoneThiazolesThiazolidinediones

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.