Trial reportDiabetes2008
Comparison of the effects of pioglitazone and metformin on hepatic and extra-hepatic insulin action in people with type 2 diabetes.
Trial report in Diabetes, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04271189 (A Prospective, Randomized, Parallel-group, Adaptive Design Phase IIb/III, Multicenter Study, to Assess the Efficacy of Polychemotherapy for Inducing Remission of Newly Diagnosed Type 2 Diabetes.), which is not on this map. Cited by 23 papers, 3 of them syntheses that pooled 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.
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.
A Prospective, Randomized, Parallel-group, Adaptive Design Phase IIb/III, Multicenter Study, to Assess the Efficacy of Polychemotherapy for Inducing Remission of Newly Diagnosed Type 2 Diabetes.
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Comparative Effects of Antidiabetic Drugs on Body Composition: A Systematic Review and Network Meta-Analysis.Diabetes, obesity & metabolism · 2026Pooled it
- Glucagon-like peptide-1 receptor agonist-based regimens compared with metformin-based regimens for preventing cardiovascular disease in adults with type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2026Pooled it
- Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2010 · on this mapPooled it
- Glycemia and Gluconeogenesis With Metformin and Liraglutide: A Randomized Trial in Youth-onset Type 2 Diabetes.The Journal of clinical endocrinology and metabolism · 2024Trial
- Pioglitazone after Ischemic Stroke or Transient Ischemic Attack.The New England journal of medicine · 2016 · on this mapTrial
- Trial
- Effect of pioglitazone treatment on endoplasmic reticulum stress response in human adipose and in palmitate-induced stress in human liver and adipose cell lines.American journal of physiology. Endocrinology and metabolism · 2008Trial
- A new oral model of free fatty acid kinetics to assess lipolysis in subjects with and without type 2 diabetes.American journal of physiology. Endocrinology and metabolism · 2023Article
- Review
- Targeting Adrenergic Receptors in Metabolic Therapies for Heart Failure.International journal of molecular sciences · 2021Review
- Metformin improves blood glucose by increasing incretins independent of changes in gluconeogenesis in youth with type 2 diabetes.Diabetologia · 2020Observational
- Mechanisms of action of metformin with special reference to cardiovascular protection.Diabetes/metabolism research and reviews · 2019Review
- The Eeffect of Metformin Combined with Calcium-Vitamin DAdvanced pharmaceutical bulletin · 2018Article
- Lack of Effects of Metformin and AICAR Chronic Infusion on the Development of Hypertension in Dahl Salt-Sensitive Rats.Frontiers in physiology · 2017Article
- Review
- Combining metformin therapy with caloric restriction for the management of type 2 diabetes and nonalcoholic fatty liver disease in obese rats.Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme · 2015Article
- Combining metformin and aerobic exercise training in the treatment of type 2 diabetes and NAFLD in OLETF rats.American journal of physiology. Endocrinology and metabolism · 2014Article
- Metformin prevents and reverses inflammation in a non-diabetic mouse model of nonalcoholic steatohepatitis.PloS one · 2012Article
- Which is the eligible patient to be treated with pioglitazone? The expert view.Journal of endocrinological investigation · 2011Article
- The influence of sex, body composition, and nonesterified fatty acids on serum adipokine concentrations.Metabolism: clinical and experimental · 2009Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveTo determine mechanisms by which pioglitazone and metformin effect hepatic and extra-hepatic insulin action. RESEARCH DESIGN AND
methodsThirty-one subjects with type 2 diabetes were randomly assigned to pioglitazone (45 mg) or metformin (2,000 mg) for 4 months.
resultsGlucose was clamped before and after therapy at approximately 5 mmol/l, insulin raised to approximately 180 pmol/l, C-peptide suppressed with somatostatin, glucagon replaced at approximately 75 pg/ml, and glycerol maintained at approximately 200 mmol/l to ensure comparable and equal portal concentrations on all occasions. Insulin-induced stimulation of glucose disappearance did not differ before and after treatment with either pioglitazone (23 +/- 3 vs. 24 +/- 2 micromol x kg(-1) x min(-1)) or metformin (22 +/- 2 vs. 24 +/- 3 micromol x kg(-1) x min(-1)). In contrast, pioglitazone enhanced (P < 0.01) insulin-induced suppression of both glucose production (6.0 +/- 1.0 vs. 0.2 +/- 1.6 micromol x kg(-1) x min(-1)) and gluconeogenesis (n = 11; 4.5 +/- 0.9 vs. 0.8 +/- 1.2 micromol x kg(-1) x min(-1)). Metformin did not alter either suppression of glucose production (5.8 +/- 1.0 vs. 5.0 +/- 0.8 micromol x kg(-1) x min(-1)) or gluconeogenesis (n = 9; 3.7 +/- 0.8 vs. 2.6 +/- 0.7 micromol x kg(-1) x min(-1)). Insulin-induced suppression of free fatty acids was greater (P < 0.05) after treatment with pioglitazone (0.14 +/- 0.03 vs. 0.06 +/- 0.01 mmol/l) but unchanged with metformin (0.12 +/- 0.03 vs. 0.15 +/- 0.07 mmol/l).
conclusionsThus, relative to metformin, pioglitazone improves hepatic insulin action in people with type 2 diabetes, partly by enhancing insulin-induced suppression of gluconeogenesis. On the other hand, both drugs have comparable effects on insulin-induced stimulation of glucose uptake.
Indexed as
Identifiers
What Socratic holds
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.