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Diabetes and Vascular Disease Research
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Long-term effects of pioglitazone versus gliclazide on hepatic and humoral coagulation factors in patients with type 2 diabetes

Gabriele Perriello

Section of Internal Medicine, Endocrinology and Metabolism, Department of Internal Medicine, University of Perugia, Perugia, Italy.

Simone Pampanelli

Section of Internal Medicine, Endocrinology and Metabolism, Department of Internal Medicine, University of Perugia, Perugia, Italy.

Paolo Brunetti

Section of Internal Medicine, Endocrinology and Metabolism, Department of Internal Medicine, University of Perugia, Perugia, Italy.

Cinzia Di Pietro

Segundo Mariz

(Formerly) TGRD (Europe), Arundel Great Court, London, WC2R 3DA, UK.

This study compared the long-term effects of pioglitazone and gliclazide on the production of coagulation factors in patients with type 2 diabetes. Patients (n=283) with glycosylated haemoglobin > 7.5% were randomised to receive either pioglitazone (30–45 mg/day) or gliclazide (80–320 mg/day) for one year. Coagulation factors were measured at baseline and at six and 12 months. While both pioglitazone and gliclazide induced a comparable improvement in glycaemic control, only pioglitazone improved insulin sensitivity. Pioglitazone significantly (p<0.001) decreased circulating levels of von Willebrand factor (-9.7%, –9.4%) and plasminogen activator inhibitor-1 (-16.8 ng/ml, –12.3 ng/ml), and increased levels of antithrombin-III (+1.3 mg/dL, +1.5 mg/dL) after six and 12 months, respectively. The beneficial effects of pioglitazone on glycaemic control, lipid homeostasis, and coagulation and thrombosis, may improve vascular outcomes in patients with type 2 diabetes.

Key Words: cardiovascular disease • coagulation • diabetes • gliclazide • pioglitazone • thrombosis

Diabetes and Vascular Disease Research, Vol. 4, No. 3, 226-230 (2007)
DOI: 10.3132/dvdr.2007.044
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