The effects of pioglitazone on postprandial glucose and lipid metabolism and vascular function - The effects of pioglitazone on postprandial metabolism and vascular function

The part of results were presented at the 73rd annual meeting of Japanese circulation society. Title The Effects of Pioglitazone on Postprandial Central Blood Pressure Regulation in Patients with Type 2 Diabetes Mellitus Abstract Background: We demonstrated blunted central blood pressure (CBP) response in postprandial state, possibly relevant to decreased nitric oxide (NO) bioavailability and activated oxidative stress due to insulin resistance, in patients with metabolic syndrome. On the other hand, little is known about the effects of improving insulin sensitivity in vivo on postprandial state. Methods: 18 consecutive patients with type 2 diabetes mellitus (T2DM) were enrolled this investigation. CBPs were assessed by augmentation index of radial artery using HEM-9000 AI (Omron Healthcare, Kyoto, Japan) during fasting state, 60 and 120 min after meal intake (Calorie mate 500kcal), and same protocol was repeated 6 months after pioglitazone treatment. Results: Both HOMA index and total insulin secretion during meal loading were significantly lowered by pioglitazone treatment. The sum of CBPs reduction 60 and 120 min after meal loading was also enlarged from 19 to 33 (P<0.05) by pioglitazone treatment despite no significant change in fasting CBP. The degree of CBP reduction and serum insulin level 120 min after meal loading showed a positive significant relationship (r=0.504, P<0.05) after treatment. Conclusion: Chronic treatment with pioglitazone shows a decline in postprandial CBP levels in T2DM. This indicate the possibility of administrating pioglitazone to suppress atherosclerotic progression by increasing NO bioavailability and diminishing oxidative stress especially in postprandial state.