Pioglitazone reduced risk of type 2 diabetes by 72% vs placebo hr 28; 95% ci 16 49



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Pioglitazone reduced risk of type 2 diabetes by 72% vs. placebo (HR 0.28; 95% CI 0.16–0.49 P<0.001)

  • Pioglitazone reduced risk of type 2 diabetes by 72% vs. placebo (HR 0.28; 95% CI 0.16–0.49 P<0.001)

  • Conversion to normal glucose tolerance: 48% of patients with pioglitazone vs 28% with placebo (P<0.001)

  • Pioglitazone reduced fasting glucose, 2-hour glucose, HbA1c

  • Weight gain, edema observed in the pioglitazone arm









Brief (1-2 week) drug washout study at end of Diabetes Prevention Program trial

  • Brief (1-2 week) drug washout study at end of Diabetes Prevention Program trial

  • After washout, diabetes was more frequently diagnosed in metformin vs. placebo (1.49; 0.93, 2.38; P=0.098)

  • DPP primary analysis: metformin decreased diabetes risk by 31%

  • Washout: 26% accounted for by pharmacological effect of metformin

  • Postwashout: diabetes reduced by 25%























We must identify patients at highest risk (prediabetes)







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