Trial reportDiabetes care2016
Pioglitazone Prevents Diabetes in Patients With Insulin Resistance and Cerebrovascular Disease.
Trial report in Diabetes care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 4 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 4 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack.The Cochrane database of systematic reviews · 2023Pooled it
- Improvement of Insulin Sensitivity Increases Pregnancy Rate in Infertile PCOS Women: A Systemic Review.Frontiers in endocrinology · 2021Pooled it
- Pioglitazone for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2020 · on this mapPooled it
- Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack.The Cochrane database of systematic reviews · 2017Pooled it
- Impact of Fixed Combination of Metformin and Pioglitazone on Insulin Resistance of Patients with Type 2 Diabetes: Results of a Randomized Open-Label Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023Trial
- Coordinated regulation of gene expression and microRNA changes in adipose tissue and circulating extracellular vesicles in response to pioglitazone treatment in humans with type 2 diabetes.Frontiers in endocrinology · 2022Trial
- Lipid metabolism in homeostasis and disease.Signal transduction and targeted therapy · 2026Review
- Clinical efficacy of liraglutide combined with pioglitazone in obese polycystic ovary syndrome and its effects on the serum chemerin/visfatin ratio.American journal of translational research · 2026Article
- 3. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Fasting plasma glucose outperformed 1-hour plasma glucose in predicting diabetes incidence in individuals with family history of young-onset type 2 diabetes.BMJ open diabetes research & care · 2025Article
- An Alternatively Translated Isoform of PPARG Suggests AF-1 Domain Inhibition as an Insulin Sensitization Target.Diabetes · 2025Article
- 3. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- Glymphatic function and its influencing factors in different glucose metabolism states.World journal of diabetes · 2024Article
- 3. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes-2024.Diabetes care · 2024Review
- 3. Prevention or Delay of Type 2 Diabetes and Associated Comorbidities: Standards of Care in Diabetes-2023.Diabetes care · 2023Review
- Triglyceride-glucose index level and variability and outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention: an observational cohort study.Lipids in health and disease · 2022Observational
- The Impact of Insulin Resistance on Hepatic Fibrosis among United States Adults with Non-Alcoholic Fatty Liver Disease: NHANES 2017 to 2018.Endocrinology and metabolism (Seoul, Korea) · 2022Article
- PPAR-Targeted Therapies in the Treatment of Non-Alcoholic Fatty Liver Disease in Diabetic Patients.International journal of molecular sciences · 2022Review
- Research progress on risk factors related to intracranial artery, carotid artery, and coronary artery stenosis.Frontiers in cardiovascular medicine · 2022Review
- Pioglitazone use associated with reduced risk of the first attack of ischemic stroke in patients with newly onset type 2 diabetes: a nationwide nested case-control study.Cardiovascular diabetology · 2021Observational
Corrections and comments
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Authors and funding
13 authors at 8 institutions in 1 country.
Funding
Abstract
objectiveThe Insulin Resistance Intervention after Stroke (IRIS) trial recently found that pioglitazone reduced risk for stroke and myocardial infarction in patients with insulin resistance but without diabetes who had had a recent ischemic stroke or transient ischemic attack (TIA). This report provides detailed results on the metabolic effects of pioglitazone and the trial's prespecified secondary aim of diabetes prevention. RESEARCH DESIGN AND
methodsA total of 3,876 patients with recent ischemic stroke or TIA, no history of diabetes, fasting plasma glucose (FPG) <126 mg/dL, and insulin resistance by homeostasis model assessment of insulin resistance (HOMA-IR) score >3.0 were randomly assigned to pioglitazone or placebo. Surveillance for diabetes onset during the trial was accomplished by periodic interviews and annual FPG testing.
resultsAt baseline, the mean FPG, HbA1c, insulin, and HOMA-IR were 98.2 mg/dL (5.46 mmol/L), 5.8% (40 mmol/mol), 22.4 μIU/mL, and 5.4, respectively. After 1 year, mean HOMA-IR and FPG decreased to 4.1 and 95.1 mg/dL (5.28 mmol/L) in the pioglitazone group and rose to 5.7 and 99.7 mg/dL (5.54 mmol/L), in the placebo group (all P < 0.0001). Over a median follow-up of 4.8 years, diabetes developed in 73 (3.8%) participants assigned to pioglitazone compared with 149 (7.7%) assigned to placebo (hazard ratio [HR] 0.48 [95% CI 0.33-0.69]; P < 0.0001). This effect was predominately driven by those with initial impaired fasting glucose (FPG >100 mg/dL [5.6 mmol/L]; HR 0.41 [95% CI 0.30-0.57]) or elevated HbA1c (>5.7% [39 mmol/mol]; HR 0.46 [0.34-0.62]).
conclusionsAmong patients with insulin resistance but without diabetes who had had a recent ischemic stroke or TIA, pioglitazone decreased the risk of diabetes while also reducing the risk of subsequent ischemic events. Pioglitazone is the first medication shown to prevent both progression to diabetes and major cardiovascular events as prespecified outcomes in a single trial.
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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.