Effects of Metformin and Pioglitazone on impaired glucose tolerance patients—An open level prospective study

Introduction: impaired glucose tolerance (IGT) often leads to type 2 diabetes (T2DM) and macro vascular disease; and usually associated with insulin resistance. Pioglitazone and metformin are commonly used insulin sensitizers (IS); and can prevent or delay the development T2DM and macro vascular disease. This study was deployed to search the better IS between these two in relation to plasma glucose and lipid control; and physical parameter altering effect. Materials and methods: 100 IGT patients selected randomly from outpatients department following prefixed inclusion and exclusion criteria. Pioglitazone and metformin were administered sequentially. Washout period was 2 weeks. Total follow up period was 24 weeks. Results: 70 IGT patients had completed the study. Metformin had reduced plasma glucose (fasting & postprandial), lipids and physical parameters significantly (p < 0.05) more than Pioglitazone. Discussion: Metformin, a hepatic insulin sensitizer, is more effective than PPAR-□ agonist Pioglitazone in the treatment of IGT; and this is due to the expression of PPAR-□ is more in adipose tissue but postprandial utilization of plasma glucose is more in muscle tissue.