Troglitazone In Obese Non-Diabetic Patients

There is little doubt that the primary goal in patients with diabetes is the tight control of blood glucose levels to prevent the many complications that affect these patients. However, relatively little work has been carried out on normal, obese patients with insulin resistance who are at risk of developing diabetes.

Now, a controlled clinical trial of troglitazone, a thiazolidinedione in development at Parke-Davis (USA) and Sankyo (Japan), has shown that the drug can improve glucose tolerance, reduce insulin resistance and induce a small but significant reduction in arterial blood pressure in obese non-diabetic patients.

18 patients were included in the study (New England Journal of Medicine, November 3) and received placebo or 200mg oral troglitazone twice-daily for 12 weeks. Nine of the patients had impaired glucose tolerance. No changes were observed in the placebo group, but those on troglitazone had improvements in glucose disposal, the insulin-sensitivity index and glycemic response to both oral glucose and mixed meals. The mean fasting plasma insulin concentration decreased by 48% and the plasma insulin response to oral glucose and mixed meals decreased by 40% and 41%, respectively. These changes were similar in the patients with normal and impaired glucose tolerance. Also, systolic and diastolic blood pressure decreased slightly in the treated group.