The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index; 4 of the 26 sources its claims cite were checked for support.
Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance
Open accessAbstract
BACKGROUND: Impaired glucose tolerance is associated with increased rates of cardiovascular disease and conversion to type 2 diabetes mellitus. Interventions that may prevent or delay such occurrences are of great clinical importance. METHODS: We conducted a randomized, double-blind, placebo-controlled study to examine whether pioglitazone can reduce the risk of type 2 diabetes mellitus in adults with impaired glucose tolerance. A total of 602 patients were randomly assigned to receive pioglitazone or placebo. The median follow-up period was 2.4 years. Fasting glucose was measured quarterly, and oral glucose tolerance tests were performed annually. Conversion to diabetes was confirmed on the basis of the results of repeat testing. RESULTS: Annual incidence rates for type 2 diabetes mellitus were 2.1% in the pioglitazone group and 7.6% in the placebo group, and the hazard ratio for conversion to diabetes in the pioglitazone group was 0.28 (95% confidence interval, 0.16 to 0.49; P<0.001). Conversion to normal glucose tolerance occurred in 48% of the patients in the pioglitazone group and 28% of those in the placebo group (P<0.001). Treatment with pioglitazone as compared with placebo was associated with significantly reduced levels of fasting glucose (a decrease of 11.7 mg per deciliter vs. 8.1 mg per deciliter [0.7 mmol per liter vs. 0.5 mmol per liter], P<0.001), 2-hour glucose (a decrease of 30.5 mg per deciliter vs. 15.6 mg per deciliter [1.6 mmol per liter vs. 0.9 mmol per liter], P<0.001), and HbA(1c) (a decrease of 0.04 percentage points vs. an increase of 0.20 percentage points, P<0.001). Pioglitazone therapy was also associated with a decrease in diastolic blood pressure (by 2.0 mm Hg vs. 0.0 mm Hg, P=0.03), a reduced rate of carotid intima-media thickening (31.5%, P=0.047), and a greater increase in the level of high-density lipoprotein cholesterol (by 7.35 mg per deciliter vs. 4.5 mg per deciliter [0.4 mmol per liter vs. 0.3 mmol per liter], P=0.008). Weight gain was greater with pioglitazone than with placebo (3.9 kg vs. 0.77 kg, P<0.001), and edema was more frequent (12.9% vs. 6.4%, P=0.007). CONCLUSIONS: As compared with placebo, pioglitazone reduced the risk of conversion of impaired glucose tolerance to type 2 diabetes mellitus by 72% but was associated with significant weight gain and edema. (Funded by Takeda Pharmaceuticals and others; ClinicalTrials.gov number, NCT00220961.).
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Claims the paper makes
4 of 26 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Because hyperglycemia plays a central role in the microvascular and macrovascular complications of diabetes, 3,5,6 it is possible that interventions that prevent or delay hyperglycemia may effectively prevent or delay these long-term complications.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > RESULTS
What the sources say
- Not checked — no full text of the sourcecites [3] source
- Not checked — no full text of the sourcecites [5] source
- Partly supportedcites [6] sourceExperimental — accuracy not yet measured
In the opening results passage (page unavailable), the paper says hyperglycemia plays a central role in microvascular complications of type 1 diabetes. A later results passage says differences in glycosylated hemoglobin accounted for much of the cardiovascular benefit of intensive therapy, supporting a role in macrovascular disease. The claim extends these type 1 findings to diabetes generally and states the macrovascular role more definitively than the paper does. (LLM, conf=0.83)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As compared with placebo, pioglitazone reduced the risk of conversion of impaired glucose tolerance to type 2 diabetes mellitus by 72% but was associated with significant weight gain and edema.”
- Also stated in: § Follow-up · plain
“The hazard ratio for development of diabetes in the pioglitazone group was 0.28 (95% confidence interval, 0.16 to 0.49; P<0.001).”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Follow-up · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Triglyceride levels declined significantly with pioglitazone (129±7.5 to 110±4.0 mg per deciliter [7.2±0.42 to 6.1±0.22 mmol per liter], P = 0.007) but not with placebo (124±4.6 to 113±4.0 mg per deciliter [6.9±0.25 to 6.30±0.22mmol per liter], P = 0.90); the difference between groups was not significant.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Effects of Pioglitazone
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Triglyceride levels declined significantly with pioglitazone (129±7.5 to 110±4.0 mg per deciliter [7.2±0.42 to 6.1±0.22 mmol per liter], P = 0.007) but not with placebo (124±4.6 to 113±4.0 mg per deciliter [6.9±0.25 to 6.30±0.22mmol per liter], P = 0.90); the difference between groups was not significant.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Effects of Pioglitazone
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As compared with placebo, pioglitazone reduced levels of both alanine aminotranferase and aspartate aminotransferase (P<0.001).”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Effects of Pioglitazone
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Insulin sensitivity as measured with the Matsuda index increased more with pioglitazone than with placebo (4.31±0.24 to 7.65±0.34vs.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Effects of Pioglitazone
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As compared with placebo, pioglitazone reduced levels of both alanine aminotranferase and aspartate aminotransferase (P<0.001).”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Effects of Pioglitazone
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Triglyceride levels declined significantly with pioglitazone (129±7.5 to 110±4.0 mg per deciliter [7.2±0.42 to 6.1±0.22 mmol per liter], P = 0.007) but not with placebo (124±4.6 to 113±4.0 mg per deciliter [6.9±0.25 to 6.30±0.22mmol per liter], P = 0.90); the difference between groups was not significant.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Effects of Pioglitazone
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As compared with placebo, pioglitazone reduced the risk of conversion of impaired glucose tolerance to type 2 diabetes mellitus by 72% but was associated with significant weight gain and edema.”
- Also stated in: § RESULTS · plain
“Weight gain was greater with pioglitazone than with placebo (3.9 kg vs. 0.77 kg, P<0.001)”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Abstract
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“HbA 1c (a decrease of 0.04 percentage points vs. an increase of 0.20 percentage points, P<0.001)”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > RESULTS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- Probably not a substantial claim. 16
- It may state two separate claims as one. 18
- The quote only partly states this claim. 1
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“In one study, 9 the use of rosiglitazone decreased the risk of diabetes in adults with impaired glucose tolerance by 62%; given concerns about cardiovascular safety, 14 however, the Food and Drug Administration has restricted the use of rosig litazone therapy to patients in whom glycemic control cannot be achieved with other medications and who cannot take pioglitazone.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > RESULTS
What the sources say
- Could not verifycites [14] sourceExperimental — accuracy not yet measured
The Results report increased odds of myocardial infarction with rosiglitazone, supporting the cardiovascular-safety concern immediately preceding citation 14. But the supplied claim concerns an FDA restriction: the Discussion describes FDA approval criteria, not a restriction limiting rosiglitazone to patients who cannot use other medications or pioglitazone. Searches for those eligibility conditions found no supporting passage in our copy. (LLM, conf=0.76)
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Could not verify
Every source the paper cites for this claim was checked and supports it.
In the paper
“The natural history of type 2 diabetes mellitus has been well defined, 4 starting with a genetic predisposition and progression from normal glucose tolerance with insulin resistance to impaired glucose tolerance and eventually type 2 diabetes mellitus with the superimposition of beta-cell failure.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > RESULTS
What the sources say
- Supportedcites [4] source
The “Natural History of Type 2 Diabetes” section describes inherited insulin resistance with initially normal glucose tolerance, progression from normal glucose tolerance to impaired glucose tolerance, and then overt diabetes as β-cell function declines. No page number is supplied in the passages. (LLM, conf=0.94)
Strength:boosted· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Studies have shown that the rate of conversion of impaired glucose tolerance to type 2 diabetes mellitus is reduced with lifestyle modification 7 ; the use of metformin, 7 thiazolidinediones, [8][9][10][11] or acarbose 12 ; and bariatric surgery.13”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > RESULTS
What the sources say
- Not checked — no full text of the sourcecites [7] source
- Not checked — no full text of the sourcecites [8] source
- Not checked — no full text of the sourcecites [9] source
- Partly supportedcites [10] sourceExperimental — accuracy not yet measured
This citation is attached to the thiazolidinediones clause, not the other interventions. The Discussion reports that troglitazone reduced diabetes incidence by 75% during treatment, but explicitly says whether other thiazolidinediones are effective remains to be determined. It therefore supports troglitazone, not the class-wide claim without qualification. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [11] source
- Not checked — no full text of the sourcecites [12] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The number of people who would need to be treated to prevent one case of diabetes was 8 for 2.2 years of the trial and 18 for 1 year.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Follow-up
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During a median follow-up period of 2.4 years (mean, 2.2), diabetes developed in 50 of the 299 patients in the placebo group (16.7%) and in 15 of the 303 patients in the pioglitazone group (5.0%).”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Follow-up
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Protection from diabetes with pioglitazone was of similar magnitude (with no significant heterogeneity) in subgroups defined by sex, age, weight, race or ethnic group, and fasting glucose level, as well as in patients with both impaired glucose tolerance and impaired fasting glucose and those with isolated impaired glucose tolerance (Fig. 3).”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Effects of Pioglitazone
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Neither pioglitazone nor placebo altered levels of low-density lipoprotein cholesterol.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Effects of Pioglitazone
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nine fractures occurred in 8 of the patients receiving pioglitazone (3%) and eight fractures occurred in 7 of the patients receiving placebo (2.6%) (Table 4 in the Supplementary Appendix).All fractures were associated with trauma.”
- Also stated in: § Discussion · plain
“Although an increased incidence of fractures has been reported with the use of thiazolidinediones, in this study, the incidence was similar in both groups, and all fractures were related to trauma.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Adverse Events
Strength:plain· not yet calibratedn = 8Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Events related to the cardiovascular system numbered 23 in the placebo group (7.7%) and 26 in the pioglitazone group (8.6%) (Table 3 in the Supplementary Appendix), with 1 case of congestive heart failure in each group (0.3%).”
- Also stated in: § Discussion · plain
“Physician-reported congestive heart failure developed in only one patient in each group.”
- Also stated in: § Discussion · plain
“For the comparison of placebo and pioglitazone regarding frequency of edema, cardiovascular events, and total events, P = 0.007, P = 0.80, and P = 0.03, respectively.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Adverse Events
Strength:plain· not yet calibratedSingle caseTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one. The quote only partly states this claim.
- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The ratio of urinary microalbumin to creatinine was low at baseline; during the study it fell slightly and similarly in the two groups (1.85±0.2 to 1.53±0.2mg per gram in the pioglitazone group vs. 1.47±0.3 to 1.25±0.3mg per gram in the placebo group, P = 0.20).”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Effects of Pioglitazone
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although pioglitazone is a well-documented insulin sensitizer, insulin resistance was reduced according to the Matsuda index of insulin sensitivity measured during the oral glucose-tolerance test but not according to measurement of insulin sensitivity during the frequent-sampling intravenous glucose-tolerance test.”
- Also stated in: § Discussion · plain
“Insulin sensitivity as determined with the use of an intravenous glucose-tolerance test with frequent sampling in a subgroup of 191 patients was not altered in either group.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pioglitazone was associated with lower diastolic blood pressure, higher levels of HDL cholesterol, and reduced rates of carotid intima-media thickening, as compared with placebo.”
- Also stated in: § Discussion · plain
“Use of pioglitazone improved diastolic blood pressure, HDL cholesterol levels, and serum levels of alanine aminotranferase and aspartate aminotransferase, and it slowed progression of carotid intima-media thickening.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One unexplained sudden death oc-curred in the placebo group, and three deaths occurred in the pioglitazone group (one unexplained sudden death, one death from biliary carcinoma, and one death from a carcinoid tumor).”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Adverse Events
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Edema and weight gain were greater with pioglitazone than with placebo, as reported previously, 8,40 and edema largely accounted for the increase in adverse events associated with pioglitazone.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
What the sources say
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We calculated that enrollment of approximately 600 patients was required to achieve 90% power, if treatment with pioglitazone decreased the rate of conversion from impaired glucose tolerance to type 2 diabetes mellitus by 50%.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Statistical Analysis
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In one study, 9 the use of rosiglitazone decreased the risk of diabetes in adults with impaired glucose tolerance by 62%; given concerns about cardiovascular safety, 14 however, the Food and Drug Administration has restricted the use of rosig litazone therapy to patients in whom glycemic control cannot be achieved with other medications and who cannot take pioglitazone.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > RESULTS
What the sources say
- Not checked — no full text of the sourcecites [9] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, further glycemic separation between groups over time would presumably have a beneficial effect on microvascular disease.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Since neither approach produced statistically significant evidence of bias due to missing data, the primary and secondary analyses were performed without data imputation.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Statistical Analysis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Takeda Pharmaceuticals provided financial support for the study but had no access to the data.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Study Design
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All results were transmitted to the Data Coordinating Center in Phoenix, Arizona, where they were recorded and audited and then sent to the Data Analysis Center in San Antonio.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Study Design
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study was conducted in accordance with the protocol.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Study Design
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Troglitazone was reported to be associated with a 55% decrease in the rate of conversion to diabetes among women with prior gestational diabetes, 11 but this agent is no longer available.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > RESULTS
What the sources say
- Not checked — no full text of the sourcecites [11] source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The small difference in levels of HbA 1c between the two groups is not surprising, given the low baseline level of HbA 1c in patients with impaired glucose tolerance.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The rate of adherence to the study regimen, assessed by means of pill counts, was greater than 80% in both groups.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Follow-up
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, if development of diabetic hyperglycemia can be delayed or prevented, it is plausible that the onset of microvascular complications might be slowed.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
Tests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is not feasible to conduct studies of microvascular outcomes in patients with impaired glucose tolerance because of the large sample and long study duration required.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Loss to follow-up was relatively high in both study groups (24% in the placebo group and 30% in the pioglitazone group, not a significant dif-ference).”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Microvascular and macrovascular complications are common in type 2 diabetes mellitus and are related to both the severity and the duration of hyperglycemia. 3”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > RESULTS
What the sources say
- Not checked — no full text of the sourcecites [3] source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We conducted a randomized, double-blind, placebo-controlled study to examine whether pioglitazone can reduce the risk of type 2 diabetes mellitus in adults with impaired glucose tolerance.”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > METHODS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“However, the greater the weight gain, the greater the improvements in betacell function and insulin sensitivity, and thus the greater the reduction in HbA 1c .26,35,36”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
What the sources say
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Carotid intima-media thickening is highly correlated with cardiovascular events, and changes in this measure over time have predictive value beyond that of standard markers of risk.18,38”
§ Pioglitazone for Diabetes Prevention in Impaired Glucose Tolerance > Discussion
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper relies on this without support.
Impaired glucose tolerance is associated with increased rates of cardiovascular disease.
“Impaired glucose tolerance is associated with increased rates of cardiovascular disease and conversion to type 2 diabetes mellitus.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“There is strong evidence that oral glucose-lowering medications approved for DM reduce the progression of prediabetes to DM.888–896”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [890]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Metformin can also be combined with linagliptin to decrease DM incidence over that observed with metformin alone.890”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [890]
Experimental — accuracy not yet measuredIn the citing paper
“However, these hypotheses are based on results from the Swedish Obese Subjects Study in which subjects were not randomized and the control group was contemporaneously matched, only received conventional treatment, and differed by a number of characteristics at baseline.”
From Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future (2014) · cites this paper as [174]
In the citing paper
“Other studies have reported lower conversion rates29 (19% in controls in the DPP Outcomes study).15”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [29]
In the citing paper
“Pioglitazone showed effectiveness in the ACT NOW Study on obese people with IGT. The risk of diabetes decreased by >70% and the drug was associated with improved diastolic blood pressure, improved HDL-cholesterol and a reduced rate of carotid intima-media thickening. However, weight gain was greater with pioglitazone (~3 kg compared to placebo) and edema was more frequently reported (13% vs. 6%).”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [29]
In the citing paper
“In Actos Now for Prevention of Diabetes (ACT NOW), treatment with pioglitazone 45 mg per day reduced incident diabetes 72% over 2.4 years in patients with IGT and at least one other risk factor for T2DM and BMI ≥ 25 kg/m2.203”
From The Vasculature in Prediabetes (2018) · cites this paper as [203]
In the citing paper
“Thiazolidinediones prevent the development of diabetes in individuals with IFG or IGT.”
From The Vasculature in Prediabetes (2018) · cites this paper as [203]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Placebo fracture percentage does not match its patient count
MinorSeven of 299 placebo patients is about 2.34%, which rounds to 2.3% at the reported precision, not 2.6%.
Reported 2.6 · recomputed 2.341137
“eight fractures occurred in 7 of the patients receiving placebo (2.6%)”
Pioglitazone baseline BMI differs between sections
MinorTable 1 gives the pioglitazone group's baseline mean BMI as 33.0, whereas the later baseline-to-follow-up values give it as 34.1.
“Mean BMI 33.0±0.434.5±0.40.44”
“34.1±0.4 to 35.5±0.4,and 40.0±0.8 to 41.9±0.7%,respectively), but the increments were greater with pioglitazone”
Triglyceride conversion is too high
MinorUsing the paper's triglyceride conversion factor of 0.01129, 129 mg per deciliter is about 1.46 mmol per liter, not 7.2.
Reported 7.2 · recomputed 1.45641
“Triglyceride levels declined significantly with pioglitazone (129±7.5 to 110±4.0 mg per deciliter [7.2±0.42 to 6.1±0.22 mmol per liter], P = 0.007)”
HDL cholesterol conversion is too high
MinorThe paper specifies a cholesterol conversion factor of 0.02586, which converts 40 mg per deciliter to about 1.03 mmol per liter, not 2.2.
Reported 2.2 · recomputed 1.0344
“The change in high-density lipoprotein (HDL) cholesterol was greater with pioglitazone (40±1 to 48±1 mg per deciliter [2.2±0.06 to 2.7±0.06 mmol per liter])”
Citations
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“In patients with impaired glucose tolerance (43) and hypertension (44), pioglitazone lowered diastolic blood pressure robustly, without major effects on systolic pressure, and in other studies, it improved both systolic and diastolic pressure (45).”
BackgroundThe global agenda for the prevention of type 2 diabetes
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Reducing the Risk of Developing Diabetes
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Glycosylated Hemoglobin for Diagnosis of Prediabetes in Acute Ischemic Stroke Patients
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Posttransplant diabetes mellitus: recent developments in pharmacological management of hyperglycemia
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“As previously reviewed [13], the conversion from prediabetes to T2D can be effectively prevented using lifestyle modifications [9, 14-16], antidiabetic drugs [9, 16-19], weight loss medications [20], and metabolic surgery [21, 22].”
BackgroundRavindrarajah, R., Reeves, D., Howarth, E., Meacock, R., Soiland‐Reyes, C., Cotterill, S., William, W., Heller, S. R., Sutton, M., Bower, P., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-040201 · Cited by 24
Salidroside in the Treatment of NAFLD/NASH
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Gestational diabetes mellitus: A window of opportunity
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“Pharmacological preparations, such as metformin, orlistat, voglibose, acarbose and thiazolidinediones, have also been used as preventive therapy for type 2 diabetes.[5-9] Some of these drugs, such as sibutramine and rosiglitazone, have been banned because of significant adverse effects.”
BackgroundReducing the Risk of Developing Diabetes
Prebtani, A. P. H., BAJAJ, H. S., Goldenberg, R., & Mullan, Y. (2018) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2017.10.033 · Cited by 26
What are the pharmacotherapy options for treating prediabetes?
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“Because TZDs preserve both b-cell function and improve insulin sensitivity, they are very effective in preventing IGT progression to T2DM and producing durable HbA1c reduction in T2DM [15,16].”
BackgroundMethodInfluentialSelf-citationPrevention of diabetes: a strategic approach for individual patients
Shin, J., Lee, J., Kim, H., Choi, Y., Cho, J., & Yoon, K. (2012) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2357 · Cited by 22
“In the ACT NOW study using 30–45 mg doses of pioglitazone in 602 patients with IGT, pioglitazone was effective in the prevention of diabetes during a median follow-up period of 2.4 years and had higher rate of conversion from IGT to NGT [29].”
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“TZDs are used either as monotherapy or in combination with other hypoglycemic agents in diabetes [1], and recently pioglitazone has also been reported to markedly reduce the risk of type 2 diabetes in people with impaired glucose tolerance [2].”
BackgroundTricò, D., Mengozzi, A., Frascerra, S., Scozzaro, T., Mari, A., & Natali, A. (2018) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-02166 · Cited by 28
Intervention of Prediabetes by Flavonoids From Oroxylum indicum
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“Metformin [10], rosiglitazone [11], pioglitazone [12], acarbose [13] and voglibose [14] have been shown to delay the onset of T2DM, although safety and tolerability issues (e.”
BackgroundConsensus on the Prevention of Type 2 Diabetes in Chinese Adults
Tong, Y.-Z., Tong, N., Teng, W., Mu, Y., Zhao, J., Shan, Z., & Ning, G. (2017) · Chinese Medical Journal · doi:10.4103/0366-6999.200532 · Cited by 20
“Results showed that the pioglitazone lowered incidence of diabetes by 72% (Class A evidence).[48]”
BackgroundDas, S. K., & Sharma, N. (2014) · World Journal of Diabetes · doi:10.4239/wjd.v5.i2.97 · Cited by 22
Anti-diabetic drugs and NASH: from current options to promising perspectives
Smati, S., Canivet, C. M., Boursier, J., & Cariou, B. (2021) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2021.1951701 · Cited by 21
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“The ACT NOW study showed that pioglitazone reduced the risk of conversion of prediabetes to type 2 diabetes mellitus and bolstered the chances of reverting to NGR. 6 Beyond ethnic distinctions, it is important to recognize that while the ACT NOW study focused on participants with impaired glucose tolerance, the BPRP t…”
BackgroundInfluentialObesity Defined as Excess Storage of Inert Triglycerides – Do We Need a Paradigm Shift?
Sørensen, T. I. A. (2011) · Obesity Facts · doi:10.1159/000328198 · Cited by 21
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“The adverse cardiovascular side effects of thiazolidinediones [12,13] and metformin-related lactic acidosis [14] may limit use of these insulin sensitizers in critically ill patients, such as burn patients.”
Backgroundthe ACT NOW Study Investigators, Hu, X., Reaven, P. D., Saremi, A., Liu, N., Abbasi, M. A., Liu, H., & Migrino, R. Q. (2016) · EURASIP Journal on Bioinformatics and Systems Biology · doi:10.1186/s13637-016-0049-6 · Cited by 20
“Demographic, clinical, and laboratory information was collected as previously reported [6, 13] and used as variables for model building.”
BackgroundMethodInfluentialSelf-citationEffects of Pioglitazone Mediated Activation of PPAR-γ on CIDEC and Obesity Related Changes in Mice
Shamsi, B. H., Ma, C., Naqvi, S., & Xiao, Y. (2014) · PLoS ONE · doi:10.1371/journal.pone.0106992 · Cited by 21
“It enhances insulin function, and has variable effects on serum triglyceride levels in patients with DM 2 [29].”
BackgroundStandl, E., Erbach, M., & Schnell, O. (2012) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2355 · Cited by 20
“by metformin [21], alpha-glucosidase-inhibitors [22] or thiazolidinedions [23,24].”
BackgroundManaging the combination of nonalcoholic fatty liver disease and metabolic syndrome
Moscatiello, S., Luzio, R. D., Sasdelli, A. S., & Marchesini, G. (2011) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2011.629188 · Cited by 20
“004 for PIO); no significant changes in fibrosis De Fronzo, 2011 [59] Double blind RCT 602 PIO PL 2.”
BackgroundMethodMudaliar, S. R. (2023) · Journal of the Indian Institute of Science · doi:10.1007/s41745-023-00357-w · Cited by 22
Self-citationAcute exposure of beta-cells to troglitazone decreases insulin hypersecretion via activating AMPK
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“shown promise for patients with prediabetes [92,93], but agents such as bromocriptine-QR are preferred, as they may impact a multitude of hyperglycemia mediators in prediabetes”
BackgroundStump, M., Guo, D., Lu, K., Mukohda, M., Cassell, M. D., Norris, A. W., Rahmouni, K., & Sigmund, C. D. (2016) · Endocrinology · doi:10.1210/en.2016-1524 · Cited by 19
Beyond Glucose—Rethinking Prediabetes for Precision Prevention
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Approach to the Patient with Gestational Diabetes after Delivery
Buchanan, T. A., & Page, K. A. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-1515 · Cited by 19
“Diabetes Prevention Program (DPP) (27), or mitigating the adverse metabolic effects of adiposity with thiazolidinediones (25, 28, 29) have the strongest effects to slow or arrest disease progression.”
BackgroundSelf-citationMata‐Cases, M., Artola, S., Escalada, J., Loiola, P. E., Ferrer-García, J. C., Fornos, J. A., Girbés, J., & Rica, I. (2015) · Revista Clínica Española (English Edition) · doi:10.1016/j.rceng.2014.10.001 · Cited by 19
RESISTENCIA A LA INSULINA: VERDADES Y CONTROVERSIAS
Felipe Pollak, C. (2016) · Revista Médica Clínica Las Condes · doi:10.1016/j.rmclc.2016.04.006 · Cited by 19
“Pese a la alta efectividad de las glitazonas en RI (prevención de DM 2 en una magnitud similar al estilo de vida saludable y mejoría de histología hepática en EHGNA), dado su costo y reacciones adversas su uso se reserva a pacientes diabéticos y casos especiales (23, 24).”
BackgroundRhee, S. Y., Chon, S., Ahn, K. J., Woo, J., & The Korean Diabetes Prevention Study Investigators (2018) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2018.0033 · Cited by 20
Fagg, J., & Valabhji, J. (2018) · Diabetic Medicine · doi:10.1111/dme.13867 · Cited by 20
Glycated Hemoglobin Level and Mortality in a Nondiabetic Population with CKD
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The Multi-Ethnic Study of Atherosclerosis (MESA)
Lin, S. X., Berlin, I., Younge, R. G., Jin, Z., Sibley, C. T., Schreiner, P. J., Szklo, M., & Bertoni, A. G. (2012) · Cited by 18
Targeting beta-cell preservation in the management of type 2 diabetes
Boughton, C. K., Munro, N. M., & Whyte, M. (2017) · British Journal of Diabetes · doi:10.15277/bjd.2017.148 · Cited by 21
Cancer risks from diabetes therapies: Evaluating the evidence
Li, C., & Kong, D. (2014) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2014.05.006 · Cited by 18
Greabu, M., Bădoiu, S. C., Stănescu-Spînu, I.-I., Miricescu, D., Totan, A., Badoiu, S. E., Costagliola, M., & Jinga, V. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22189782 · Cited by 21
Personalised prevention of type 2 diabetes
Wareham, N. J. (2022) · Diabetologia · doi:10.1007/s00125-022-05774-7 · Cited by 17
“While there is demonstrable BMI-dependent effectiveness for metformin, there is, for example, no evidence of heterogeneity of effect by initial BMI for pioglitazone [20].”
BackgroundDabelea, D., Ma, Y., Knowler, W. C., Marcovina, S. M., Saudek, C. D., Arakaki, R., White, N. H., Kahn, S. E., Orchard, T. J., Goldberg, R. B., et al. (2014) · Diabetic Medicine · doi:10.1111/dme.12437 · Cited by 18
Does Insulin Resistance Drive the Association between Hyperglycemia and Cardiovascular Risk?
Færch, K., Bergman, B. C., & Perreault, L. (2012) · PLoS ONE · doi:10.1371/journal.pone.0039260 · Cited by 18
“The Actos Now for Prevention of Diabetes (ACT NOW) study showed beneficial effects of the insulin-sensitizing agent pioglitazone on carotid intima-media thickness in individuals with impaired glucose tolerance [19].”
BackgroundChoice of early treatment regimen and impact on β-cell preservation in type 2 diabetes
Mudaliar, S. R. D. (2013) · International Journal of Clinical Practice · doi:10.1111/ijcp.12154 · Cited by 19
Self-citationPreventive pharmacotherapy in type 2 diabetes mellitus
Kalra, S., Choudhary, N., Unnikrishnan, A., & Ajish, T. (2011) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.91183 · Cited by 18
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Valensi, P. E. (2024) · Cardiovascular Diabetology · doi:10.1186/s12933-024-02436-3 · Cited by 21
“Conversion to normal glucose tolerance occurred in 48% of the patients in the pioglitazone group and 28% of those in the placebo group [130].”
BackgroundHan, Y. Y., Hu, H., Liu, Y., Wang, Z., & Liu, D. (2022) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14910 · Cited by 17
Stuijver, D. J. F., Romualdi, E., van Zaane, B., Bax, L., Buller, H. R., Gerdes, V. E. A., & Squizzato, A. (2014) · Internal and Emergency Medicine · doi:10.1007/s11739-014-1168-2 · Cited by 17
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“Its ligands, thiazolidinediones (TZDs), such as rosiglitazone and pioglitazone, are highly effective in treating insulin resistance and type 2 diabetes mellitus (T2DM) [6–8].”
BackgroundIssues in Defining the Burden of Prediabetes Globally
Echouffo-Tcheugui, J. B., Kengne, A. P., & Ali, M. K. (2018) · Current Diabetes Reports · doi:10.1007/s11892-018-1089-y · Cited by 17
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Myocardial Insulin Resistance: An Overview of Its Causes, Effects, and Potential Therapy
Toit, E. F. D., & Donner, D. G. (2012) · InTech eBooks · doi:10.5772/50619 · Cited by 18
“years [259].”
Use of functional foods for diabetes prevention in China
Zeng, Y. (2012) · African Journal of Pharmacy and Pharmacology · doi:10.5897/ajpp12.119 · Cited by 17
“As compared with placebo, pioglitazone (Hydrochloride) reduced the risk of conversion of impaired glucose tolerance to type 2 diabetes mellitus (T2DM) by 72%, but was associated with significant weight gain and edema (DeFronzo et al., 2011).”
BackgroundTjandrawinata, R. R., Manaf, A., Malinda, D., & Susanto, L. W. (2016) · Drug Design Development and Therapy · doi:10.2147/dddt.s97568 · Cited by 18
A Review on Glycosylated Hemoglobin in Polycystic Ovary Syndrome
Rezaee, M., Asadi, N., Pouralborz, Y., Ghodrat, M., & Habibi, S. (2016) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2016.07.001 · Cited by 19
Diabetes Mellitus and the Metabolic Syndrome
Huang, P. L., & Huang, P. L. (2013) · Springer eBooks · doi:10.1007/978-1-4471-4483-0_7 · Cited by 16
Laparoscopic adjustable gastric banding and progression from impaired fasting glucose to diabetes
Wentworth, J. M., Hensman, T., Playfair, J., Laurie, C., Ritchie, M. E., Brown, W. A., Skinner, S., Shaw, J. E., & O’Brien, P. E. (2014) · Diabetologia · doi:10.1007/s00125-013-3129-0 · Cited by 16
“In moderately overweight populations with IGT, intensive lifestyle intervention [5–8] or drug therapy with metformin [5, 6], acarbose [9] or pioglitazone [10] reduces the risk of progression to type 2 diabetes by 30–70%.”
BackgroundEffects of pioglitazone versus glimepiride exposure on hepatocellular fat content in type 2 diabetes
Esther Phielix, E., Brehm, A., Bernroider, E., Krššák, M., Anderwald, C. H., Krebs, M., Schmid, A. I., Nowotny, P., & Roden, M. (2013) · Diabetes Obesity and Metabolism · doi:10.1111/dom.12112 · Cited by 16
“Pioglitazone effectively improved metabolic and histologic features of non-alcoholic steatohepatitis [15] and even reduces the risk of T2DM by 72% [16] by improving insulin sensitivity and preserving β-cell function [16–18].”
BackgroundZhao, D., Zhu, Z., Li, D., et al. (2015) · Biochemistry · doi:10.1021/acs.biochem.5b00847 · Cited by 16
Glycemic Markers and Subclinical Cardiovascular Disease: The Jackson Heart Study
Echouffo-Tcheugui, J. B., Chen, H., Kalyani, R. R., Sims, M., Simpson, S. L., Effoe, V. S., Correa, A., Bertoni, A. G., & Golden, S. H. (2019) · Circulation Cardiovascular Imaging · doi:10.1161/circimaging.118.008641 · Cited by 18
Chojkier, M., El‐Khayat, H. R., Sabry, D., Donohue, M., & Buck, M. (2012) · PLoS ONE · doi:10.1371/journal.pone.0031516 · Cited by 16
“These higher Pioglitazone doses (30 mg or 45 mg per day) have been successfully utilized to prevent the development of type 2 diabetes in patients with impaired glucose tolerance in the USA [8], in the treatment of HCV genotype 4 treatment naive patients together with PEG-Interferon-a2/ribavirin in Egypt [11] and in o…”
BackgroundMethodResultInfluentialYu, X., Chen, P., Wang, H., & Zhu, T. (2012) · Medical Principles and Practice · doi:10.1159/000341770 · Cited by 16
Goldfine, A. B., Phua, E.-J., & Abrahamson, M. J. (2014) · Circulation · doi:10.1161/circulationaha.113.006634 · Cited by 16
Kumar, V. P., & Sunandamma, Y. (2013) · International Journal of Pharmaceutical and Life Sciences · doi:10.3329/ijpls.v2i1.14580 · Cited by 16
“[7]”
Liu, T., & Li, G. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.01.058 · Cited by 16
“Recently published ACT NOW study [33] showed pioglitazone reduced the risk of conversion of impaired glucose tolerance (IGT) to type 2 diabetesmellitus by 72% in 602 IGT patients during a follow-upperiod of 2.”
BackgroundSamson, S. L., Vellanki, P., Blonde, L., Hirsch, I. B., Hoang, T. D., Isaacs, S. D., Izuora, K. E., Wang, C. C. L., Ooi, C. P., Padilla, B. I., et al. (2026) · Endocrine Practice · doi:10.1016/j.eprac.2026.01.006 · Cited by 29
Therapeutic Challenges in Diabetes Prevention: We Have Not Found the “Exercise Pill”
Srinivasan, S., & Florez, J. C. (2015) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.146 · Cited by 15
“It is also significant to note that quite a large number of participants in this study, 24% in the placebo group and 30% in the pioglitazone group, were lost to follow-up.(17) The side effects associated with all thiazolidinediones include weight gain, fluid retention, decrease in bone density and increase in fracture…”
BackgroundJetton, T. L., Flores-Bringas, P., Leahy, J. L., & Gupta, D. (2021) · Journal of Biological Chemistry · doi:10.1016/j.jbc.2021.101250 · Cited by 14
“Pioglitazone in clinical use is thought to enhance peripheral insulin sensitivity as a diabetes therapeutic agent (47, 48); however, these supportive data also demonstrate direct effects of PPARγ agonists in the functional preservation of β-cells (34).”
BackgroundLuo, Y., Wang, H., Zhou, X., Chang, C., Chen, W., Guo, X., Yang, J., Ji, L., & Paul, S. K. (2022) · Journal of Diabetes Research · doi:10.1155/2022/2971382 · Cited by 15
“If we take a look at the data in the ACT NOW study, which was also a diabetes prevention study with pioglitazone [12], the conversion to normal glucose tolerance occurred in 48% of the patients in the pioglitazone group and 28% of those in the placebo group.”
BackgroundMethodLi, J., Yu, Y., Sun, Y. B., Fu, Y., Shen, W., Cai, L., Tan, X. W., Cai, Y., Wang, N., Lu, Y., et al. (2024) · eLife · doi:10.7554/elife.98709 · Cited by 15
“…medical therapy have been proven to be effective in preventing or delaying the diabetes onset among people with prediabetes ( Gong et al., 2019 ; DeFronzo et al., 2011 ; Herman, 2023 ), the substantial cost of modification programs and medications as well as drug-related side effects limit the…”
Role of anti-diabetic medications in the management of MASLD
Isaacs, S. D., Farrelly, F. V., & Brennan, P. (2025) · Frontline Gastroenterology · doi:10.1136/flgastro-2024-102856 · Cited by 17
“23 24 Although current evidence does not support a relationship, 25 42 guidelines recommend against its use in active bladder cancer and assessment for microscopic haematuria should be considered prior to initiation.”
Mata‐Cases, M., Artola, S., Escalada, J., Loiola, P. E., Ferrer-García, J. C., Fornos, J. A., Girbés, J., & Rica, I. (2014) · Revista Clínica Española · doi:10.1016/j.rce.2014.10.012 · Cited by 16
Preventing Diabetes in American Indian Communities
Knowler, W. C., & Ackermann, R. T. (2013) · Diabetes Care · doi:10.2337/dc12-2635 · Cited by 16
Priming metabolism with the type 5 phosphodiesterase: the role of cGMP-hydrolyzing enzymes
Campolo, F., Pofi, R., Venneri, M. A., & Isidori, A. M. (2021) · Current Opinion in Pharmacology · doi:10.1016/j.coph.2021.08.007 · Cited by 16
Approach to the Patient With Nonalcoholic Fatty Liver Disease
Belfort‐DeAguiar, R., Lomonaco, R., & Cusi, K. J. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac624 · Cited by 16
Is regression to normoglycaemia clinically important?
Yakubovich, N., & Gerstein, H. C. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60828-9 · Cited by 15
Identifying prediabetes – Is it beneficial in the long run?
Ghody, P., Shikha, D., Karam, J., & Bahtiyar, G. (2015) · Maturitas · doi:10.1016/j.maturitas.2015.03.022 · Cited by 18
Prevention of obesity and diabetes in pregnancy: is it an impossible dream?
Langer, O. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2018.03.014 · Cited by 17
Tharp, W. G., Gupta, D., Sideleva, O., Deacon, C. F., Holst, J. J., Elahi, D., & Pratley, R. E. (2019) · Diabetes · doi:10.2337/db18-1163 · Cited by 15
“Clinical trials of TZDs demonstrate improved glucose and lipid control, enhanced peripheral Si, and preservation of b-cell function in prediabetes and early T2DM compared with other therapies (42,43).”
ResultHossain, K., Rahman, A. F. M. M., Sultan, M. Z., et al. (2013) · Bangladesh Pharmaceutical Journal · doi:10.3329/bpj.v16i1.14497 · Cited by 15
“It is used in the treatment of type-II diabetes mellitus (Gillies and Dunn, 2000; Smith, 2001; Belfort et al., 2006; DeFronzo et al., 2011).”
Method
Metadata
- Authors
- DeFronzo, R. A., Tripathy, D., Schwenke, D. C., Banerji, M., Bray, G. A., Buchanan, T. A., Clement, S. C., Henry, R. R., Hodis, H. N., Kitabchi, A. E., Mack, W. J., Mudaliar, S., Ratner, R. E., Williams, K., Stentz, F. B., Musi, N., & Reaven, P. D.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- Texas Diabetes Institute (US)
- Phoenix VA Health Care System (US)
- Pennington Biomedical Research Center (US)
- University of Southern California (US)
- Georgetown University (US)
- University of California San Diego (US)
- University of Tennessee Health Science Center (US)
- MedStar Health Research Institute (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2011-03-24
- Volume
- 364
- Issue
- 12
- Pages
- 1104-1115
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2131330057
- Semantic Scholar
- 2537f2b5521882869eda52ee137db9e85431749f
- Cited by
- 766
- References
- 42
- Citations by year
- 2026: 26 · 2025: 20 · 2024: 44 · 2023: 35 · 2022: 35 · 2021: 49 · 2020: 45 · 2019: 45 · 2018: 58 · 2017: 54 · 2016: 53 · 2015: 61 · 2014: 61 · 2013: 69 · 2012: 69
- FWCI
- 49.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (M01-RR00221, M01RR000043)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Peroxisome Proliferator-Activated Receptors
- Keywords
- pioglitazone, impaired glucose tolerance, type 2 diabetes prevention, thiazolidinediones, glucose tolerance, fasting blood glucose, HbA1c, carotid intima-media thickening, diastolic blood pressure, HDL cholesterol, cardiovascular risk, PPARγ agonists, statins, fibrates, nicotinic acid, fenofibrate
- MeSH terms
- Pioglitazone, Adolescent, Adult, Blood Glucose, Blood Pressure, Diabetes Mellitus, Type 2, Double-Blind Method, Edema, Follow-Up Studies, Glucose Tolerance Test, Humans, Hypoglycemic Agents, Insulin Resistance, Middle Aged, Weight Gain, Life Tables, Proportional Hazards Models, Glucose Intolerance, Thiazolidinediones, Kaplan-Meier Estimate, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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