Risk management in the treatment of type 2 diabetes with pioglitazone

INTRODUCTION Type 2 diabetes mellitus is one of the most important cardiovascular risk factors. Insulin-resistance represents the common mechanism that leads to type 2 diabetes in obese subjects. Pioglitazone is an insulin-sensitizing agent available for treatment of type 2 diabetes. Large clinical trials have demonstrated the effectiveness of pioglitazone in achieving metabolic control and reducing cardiovascular morbidity and mortality. AIM The purpose of this article is to review the effectiveness and tolerability of pioglitazone in the prevention and management of atherosclerosis in patients with type 2 diabetes. EVIDENCE REVIEW We reviewed the main monotherapy and comparative studies of pioglitazone, and particularly the recent evidence in the field of atherosclerosis and cardiovascular prevention. PLACE IN THERAPY The current evidence shows that pioglitazone is an effective option in the treatment of type 2 diabetes. More studies are needed to establish a role for pioglitazone in atherosclerosis prevention beyond glycemic control.