A Study of Effects of Pioglitazone and Rosiglitazone on Various Parameters in Patients of Type-2 Diabetes Mellitus with Special Reference to Lipid Profile.

OBJECTIVES To study the complete fasting lipid profile and other parameters (weight, body mass index, HbA1c, fasting blood sugar and postprandial blood sugar)in Type 2 diabetes mellitus patients on OHA/insulin, to study the effect of addition of pioglitazone on lipid profile and other parameters in Type 2 diabetes mellitus patients on OHA/insulin, to study the effect of addition of rosiglitazone on lipid profile and other parameters in Type 2 diabetes mellitus patients on OHA/insulin and to compare the effect of pioglitazone and rosiglitazone on lipid profile and other parameters in Type 2 diabetes mellitus patients on OHA/insulin. MATERIAL AND METHODS In the study, 100 Type 2 diabetes cases on oral hypoglycemic agent/insulin with deranged lipid profile were chosen and divided into 2 groups 50 and 50 in group A and group B respectively.Pioglitazone was given initially 15mg/day then if required increasing upto 45mg/day in group A for period of 18 weeks and rosiglitazone was given initially 2 mg/day then if required increasing upto 8 mg/day in group B for period of 18 weeks. Detailed clinical history was obtained and thorough physical examination was done and following parameters were established-Age, Height, Weight, Body mass index, Fasting and Postprandial blood sugar, HbA1c levels and fasting complete lipid profile done at 0 and 18 weeks. Each patient itself served as a control for this study. RESULTS Maximum no. of patients were in sixth decade (53.30%) and minimum patients were in seventh decade (6.6%). Males were 63.3% and females were 36.8%. Fasting blood sugar levels decreased by 23% with pioglitazone in group A and 14.07% with rosiglitazone in group B. The postprandial blood sugar levels decreased by 29.9% with pioglitazone in group A and 20.17% with rosiglitazone in group B.The mean HbA1c decreased by 2.13 % pioglitazone in group A and 3.8% with rosiglitazone in group B after 18 weeks of therapy. The effects of both drugs on BMI and weight were not significant. In group A the total cholesterol level decreased by 8.62% with pioglitazone but in group B there was no significant decrease in total cholesterol level after 18 weeks of therapy with rosiglitazone. There was no significant reduction in mean LDL cholesterol level in both groups. HDL-c level increased by 17.14% with pioglitazone in group A and decreased by 1.2% with rosiglitazone in group B. Triglycerides levels decreased by 12.33% with pioglitazone in group A and 6.16% with rosiglitazone in group B. CONCLUSIONS Treatment with pioglitazone and rosiglitazone both were associated with reduction in fasting and postprandial blood sugar levels but more with pioglitazone. There was significant reduction in HbA1c with both pioglitazone and rosiglitazone but more with rosiglitazone. The total cholesterol level decreased by pioglitazone significantly but not with rosiglitazone. The LDL levels were not affected much by both drugs, while HDL levels were significantly increased with pioglitazone. Triglycerides levels were decreased with both pioglitazone and rosiglitazone but more with pioglitazone. Both drugs are useful but pioglitazone proved to be more beneficial on deranged lipid profile as compared to rosiglitazone in Type 2 Diabetes mellitus patients on OHA/insulin.