( ” which are said to increase the body’...)Widely Prescribed Diabetes Drug Falls Short of Promise, Says New Review,Health

,” which are said to increase the body’s sensitivity to insulin produced naturally by the body, thereby allowing better uptake of glucose into the cells of the body and lowering blood glucose levels.

Physicians in the U.S. prescribe drugs such as Actos to patients with type II diabetes, whose bodies either do not produce enough natural insulin or don't use the insulin as effectively as those not affected by diabetes.

HbA1c, or hemoglobin A1c, is a blood test that assesses a patient’s blood glucose levels over time. The HbA1c number correlates with average blood glucose levels during the preceding 120 days, and most tellingly, during the previous eight to 12 weeks.

The review found that pioglitazone lowers HbA1c, but when compared to other active glucose-lowering drugs, similar reductions of HbA1c were achieved, so that "no apparent advantage of pioglitazone treatment could be demonstrated," said Richter. "Probably, the best comparison would be with metformin, where pioglitazone lowered HbA1c between 1.3 percent and 1.4 percent and metformin by 1.5 percent."

Pioglitazone has many possible side effects, including fluid retention, weight gain, and leg and ankle "edema" or swelling. In isolated cases it may lead to, or worsen, heart failure.

In the review studies, 15 percent of participants receiving pioglitazone therapy reported edema compared with 7 percent of participants in control groups.

The 15 studies that looked at body weight reported an increase of up to 8.6 pounds in those patients receiving pioglitazone treatment.

In one major study in the review, significantly more patients developed edema and heart failure, including heart failure needing hospital admission, following administration of pioglitazone — 6 percent versus 4 percent on placebo. Heart failure was reported in 11 percent of patients on pioglitazone therapy versus 8 percent on placebo.

The drug may also c
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