The type 2 diabetes
Type-2 diabetes have a resistance of body cells to the biological effects of insulin. Once this so-called insulin resistance is too strong, does the injected insulin in a diabetes therapy is not effective enough. Be increased in these cases, the insulin sensitivity by insulin sensitizers. These sensitizers are firstly used for type-2 diabetes with marked insulin resistance, ie, in patients in whom insulin alone is insufficient. On the other hand in diabetic patients who are not the standard combination of insulin and metformin because of contraindications or intolerance can take.

To date, registered in Germany, two insulin sensitizers: Pioglitazone and rosiglitazone. These drugs increase insulin sensitivity of liver cells, muscle, and adipose tissue. The cells absorb more sugar by these substances, the liver, however, limits their glucose production. The result: the blood sugar level falls, both fasting and after meals.

The study
In the current study for three years more than 4000 patients taking part. All will be treated with the combination of insulin and pioglitazone. The first interim analysis of data from 2086 patients from 408 different diabetological study centers appears very positive. The blood glucose levels of the test subjects fell by nearly one percentage point. As an ultimate goal, the leaders recommend a percentage of 6.5%. In addition, the interim results showed that 22% of patients required less insulin. Blood pressure and blood lipid values of study participants also improved.

Possible side effects
The compatibility ratio of this therapy was quite good and was 97.7%, which was tolerated in most patients, the combination without major problems. One in seven patients, there was water retention in the legs. Through a diuretic these unwanted side effects, however, were already resolved during therapy. Encouraging, the researchers expressed the fact that no patient had to discontinue the therapy and already well-known complications with pioglitazone were observed.

Treatment Information
In patients receiving the combination therapy for the first time it is very important that the physician individually reduces the insulin dose to prevent hypoglycaemia. Those in charge of the study suggest, therefore, patients in the first few weeks follow closely, especially with regard to the occurrence of Herzinsuffiziensymptomen. Particularly crucial to a problem-entry into this type of therapy is the continuous adjustment of insulin dose.