Abstract
We investigated the effect of pioglitazone and acarbose combination therapy on the progression of carotid intima-media thickness (IMT) and pulse wave velocity (PWV) in type 2 diabetic patients (n=130) with a mean HbA1c of 6.5%, blood pressure of 130/70 mmHg, and duration of diabetes of 10 years who had never been treated with these drugs. Patients were assigned to a P 30 mg plus A 300 mg group (Group I; n=77) or a group that continued current therapy without these drugs (Group C; n=53). After one year the progression of IMT was significantly reduced in Group I in comparison with Group C (-0.002±0.037 vs. 0.043±0.080 mm, p<0.0001), and the reduction was significant in patients on only diet therapy, oral hypoglycemic agents, or insulin therapy. The combination therapy was accompanied by improvement in serum concentrations of HDL-cholesterol and triglyceride levels and hs-CRP and the urinary albumin excretion rate. The changes in IMT were significantly related to the changes in HbA1c levels. Among those whose HbA1c deteriorated, the progression of IMT was reduced more in Group I than in Group C. PWV was significantly reduced in Group I, but only in the values on the left side. In conclusion, combination therapy with pioglitazone and acarbose may exert an anti-atherogenic effect, however, the underlying mechanism remains to be clarified.
