Pioglitazone is an antihyperglycemic agent. It helps the body respond better to insulin and it reduces the amount of sugar produced by the liver. It can help control blood sugar levels. Pioglitazone is a thiazolidinedione (glitazone) antidiabetic agent that is structurally and pharmacologically related to troglitazone and rosiglitazone but unrelated to other antidiabetic agents, including sulfonylureas, biguanides, and alpha-glucosidase inhibitors.
Pioglitazone acts principally by increasing insulin sensitivity in target tissues, as well as decreasing hepatic gluconeogenesis. Pioglitazone is a peroxisome proliferator-activated receptor agonist that increases transcription of insulin-responsive genes and increases insulin sensitivity. Pioglitazone, like other thiazolidinediones, ameliorates insulin resistance associated with type 2 diabetes mellitus, without stimulating insulin release from pancreatic ß-cells, thus avoiding the risk of hypoglycemia.
Pioglitazone is a drug that reduces the amount of glucose (sugar) in the blood. It is in a class of anti-diabetic drugs called "thiazolidinediones" that are used in the treatment of type II diabetes. The other member in this class is rosiglitazone (Avandia). (Another member of this class, troglitazone or Rezulin, was removed from the market because of liver toxicity.) Patients with type II diabetes cannot make enough insulin, and the cells of their body do not respond normally to the reduced amounts of insulin that are present. (Insulin is the hormone produced by the pancreas that stimulates cells to remove glucose from the blood.) Pioglitazone often is referred to as an "insulin sensitizer" because it attaches to the insulin receptors on cells throughout the body and causes the cells to become more sensitive (more responsive) to insulin. As a result, more glucose is removed from the blood. At least some insulin must be produced by the pancreas in order for pioglitazone to work.
Pioglitazone also lowers the level of glucose in the blood by reducing the production and secretion of glucose into the blood by the liver. In addition, pioglitazone may alter the blood concentrations of lipids (fats) in the blood. Pioglitazone is used for the treatment of type II diabetes along with a healthy diabetic diet, regular exercise, weight control, smoking reduction, and careful monitoring of blood glucose. Pioglitazone may be used alone or in combination with metformin, a drug in a different class of anti-diabetic drugs, that also lowers blood glucose. Since it requires naturally-secreted insulin to be effective, pioglitazone is not recommended in type I diabetes where the amount of insulin is very low or absent. Nevertheless, pioglitazone is approved for treating type II diabetes in combination with insulin as well as another class of anti-diabetic drugs, the sulfonylureas. Pioglitazone is used, along with diet and exercise, in the treatment of non-insulin-dependent diabetes mellitus (type II diabetes). Pioglitazone may also be used with a sulfonylurea (e.g., Diabeta, Glucotrol, Micronase, others), metformin (Glucophage), or insulin when diet and exercise plus any one of these medicines alone do not result in adequate blood sugar control.