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Effects of Troglitazone: A new hypoglycemic agent in patients with NIDDM poorly controlled by diet therapy

  1. Yasuhiko Iwamoto, MD,
  2. Kinori Kosaka, MD,
  3. Takeshi Kuzuya, MD,
  4. Yasuo Akanuma, MD,
  5. Yukio Shigeta, MD and
  6. Toshio Kaneko, MD
  1. Diabetes Center, Tokyo Women's Medical College, Asahi Life Foundation Tokyo
  2. Toranomon Hospital, Asahi Life Foundation Tokyo
  3. Institute for Diabetes Care and Research, Asahi Life Foundation Tokyo
  4. Division of Endocrinology and Metabolism, Jichi Medical School Tochigi
  5. Third Department of Internal Medicine, Shiga University of Medical Science Shiga
  6. Yamaguchi Rousai Hospital Yamaguchi, Japan
  1. Address correspondence and reprint requests to Yasuhiko Iwamoto, MD, Diabetes Center, Tokyo Woman's Medical College, 8–1 Kawada-cho Shinjyuku-ku Tokyo 162, Japan

Abstract

OBJECTIVE To investigate the clinical efficacy of troglitazone, a newly developed oral hypoglycemic agent, in patients with NIDDM.

RESEARCH DESIGN AND METHODS There were 284 NIDDM patients (20–82 years of age) whose glycemic control while on a diet was judged stable but was judged unsatisfactory (fasting plasma glucose [FPG] ≥ 8.3 mmol/l) when entered into a multicenter and double-blind study with parallel groups study. They were randomly allocated into two groups, the troglitazone group (the T group: 400 mg/day p.o.) and the placebo group (the P group), and were treated with test drugs for 12 weeks.

RESULTS We evaluated efficacy in 136 patients of the T group and 126 patients of the P group. There was no significant difference in any of baseline characteristics between the T and P groups. In the T group, FPG and HbA1c decreased significantly after treatment (before versus after, FPG 10.1 ± 1.6 vs. 8.8 ± 1.9 mmol/l, P < 0.001; HbA1c: 8.6 ± 1.5 vs 8.1 ± 1.7%, P < 0.001). FPG and HbA1c did not change after treatment in the P group (before versus after, FPG 10.1 ± 1.8 vs. 9.9 ± 2.1 mmol/l; HbA1c 8.5 ± 1.5 vs. 8.6 ± 1.6%). Of 136 patients in the T group, 62 (45.6%) were classified as responders. Serum triglyceride level also decreased in the T group but not in the P group. Body weight increased slightly only in the T group. There were no differences in changes in blood pressure between the two groups. No serious adverse events occurred in either group.

CONCLUSIONS Troglitazone at 400 mg/day decreased FPG and HbA1c significantly in NIDDM patients who had failed to respond to diet therapy. Troglitazone, developed as a drug to enhance insulin action, can be a useful hypoglycemic agent for the treatment of NIDDM.

  • Received May 15, 1995.
  • Revision received September 14, 1995.
  • Accepted September 14, 1995.
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