SAFETY AND EFFICACY OF PIOGLITAZONE AMONG TYPE 2 DIABETES MELLITUS PATIENTS RECEIVING LONG TERM HEMODIALYSIS
Background: Type 2 diabetes mellitus (T2DM) frequently causes end stage renal disease (ESRD). Glucose-lowering treatment options for patients with T2DM with ESRD are limited. Thiazolidinedione is an oral glucose lowering agent used to treat patients with ESRD. We evaluated the potential for pioglitazone in combination with other hypoglycemic medications among patients with T2DM receiving long term hemodialysis Objectives: To evaluate the safety and efficiency of pioglitazone among patients with ESRD receiving hemodialysis. Methods: The retrospective study was conducted in the outpatient clinic of Phramongkutklao Hospital during 2006 and 2015. HemoglobinA1C (HbA1c), fasting plasma glucose (FPG), body weight, hematocrit and history of diagnosed chronic heart failure were evaluated after starting medication and 1 year of follow-up Results: Data for hemodialysis patients on pioglitazone were analyzed (n=50). Mean FPG changes from baseline were -28.8+-80.0 mg/dL after 12 weeks (p=0.018) and -59.2+-80.0 mg/dL after 12 months of treatment (p < 0.001). Mean HbA1c changes from baseline were also-0.25+-1.62% after 12 weeks (p=0.318) and -1.52+-1.77% after 12 months of treatment (p < 0.001). The differences in mean body weight (63.2+-13.0 kg; p= 0.139) and hematocrit (33.4+-5.5 vs. 33.6+-5.3; p= 0.929) at baseline and 12 months were not significant, while episodes of congestive heart failure were low (4%). No serious adverse effects such as hypoglycemia with hospitalization or liver failure were observed in any of the patients Conclusion: These data suggest that adding pioglitazone to standard hypoglycemic agents patients with T2DM undergoing hemodialysis glucose control and was well tolerated
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