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Cited by 35Diabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and Research

Successful Treatment of Prediabetes in Clinical Practice: Targeting Insulin Resistance and β-Cell Dysfunction

Armato, John, DeFronzo, Ralph A., Abdul-Ghani, Muhammad, Ruby, Ron·2012·Endocrine Practice
DOI 10.4158/ep11194.or
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Abstract

Objective To determine the effectiveness of targeted pharmacologic interventions to reverse documented pathophysiologic abnormalities in prediabetes. Methods Patients with impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) were treated with insulin sensitizers (pioglitazone + metformin) or insulin sensitizers + exenatide on the basis of oral glucose tolerance testing-derived indices of insulin resistance and impaired β-cell function. Patients who declined pharmacologic therapy received lifestyle modification only. Results One hundred five patients with IGT and/or IFG were treated with insulin sensitizers (pioglitazone + metformin) (n = 40), insulin sensitizers + exenatide (n = 47), or lifestyle modification only (n = 18). After a mean follow-up period of 8.9 months, the lifestyle modification group demonstrated no significant changes in fasting plasma glucose, plasma glucose area under the curve during oral glucose tolerance testing, insulin sensitivity, or β-cell function. In the pioglitazone + metformin group (24 hours off medication), fasting plasma glucose fell from 109 to 102 mg/dL; plasma glucose area under the curve decreased by 12.0%; insulin sensitivity and β-cell function improved by 42% and 50%, respectively (all P Conclusions Targeted pathophysiologic therapy based on oral glucose tolerance test-derived measures of insulin sensitivity and β-cell function can be implemented in general internal medicine and endocrine practice and is associated wi…

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  • Low dose of 15 mg pioglitazone prevents reactive hypoglycemia in impaired glucose tolerance.

    “It has been reported that low dose of 15 mg pioglitazone prevents reactive hypoglycemia in impaired glucose tolerance.[41]”

    From Postprandial Reactive Hypoglycemia (2019) · cites this paper as [41]

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Authors
Armato, J., DeFronzo, R. A., Abdul-Ghani, M., & Ruby, R.
Affiliations
  • Little Company of Mary Hospital (US)
  • The University of Texas at San Antonio Health Science Center (US)
Corresponding author
Armato, John
ORCID
Venue
Endocrine Practice
Publisher
Elsevier BV
Published
2012-05
Volume
18
Issue
3
Pages
342-350
ISSN
1530-891X (ISSN-L)
DOI
10.4158/ep11194.or
OpenAlex
W2088093867
Cited by
35
References
49
Citations by year
2026: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 5 · 2014: 7 · 2013: 2 · 2012: 2
FWCI
2.88
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Endocrine Practice (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
prediabetes, impaired glucose tolerance, impaired fasting glucose, insulin resistance, beta-cell dysfunction, pioglitazone, metformin, exenatide, insulin sensitizers, lifestyle modification, oral glucose tolerance test, pharmacotherapy
MeSH terms
Pioglitazone, Exenatide, California, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Feasibility Studies, Female, Follow-Up Studies, Humans, Hyperglycemia, Hypoglycemic Agents, Insulin, Insulin Resistance, Male, Metformin, Middle Aged, Peptides, Prediabetic State, Venoms, Thiazolidinediones, Insulin-Secreting Cells, Glucagon-Like Peptide 1, General Practice, Molecular Targeted Therapy

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