Pioglitazone: From discovery to clinical practice
The most common type of diabetes is Type II diabetes mellitus which occurs in more that 90% of the cases of diabetes reported (Thomas, 2013). Type I diabetes is not as common and is caused by destruction of the islet of Langerhans due to susceptibility of an autoimmune destruction leading to a reduced amount of insulin produced and glucose intolerance (Feinglos,2008). Type I diabetes is mostly diagnosed in children and young adults. Unlike diabetes type I, Type II diabetes mellitus is mostly diagnosed in older people and is caused by unhealthy lifestyles (Thomas, 2013).
Type II diabetes is characterized by production of insulin which does not perform its function. It in turn leads to a situation referred to as insulin resistance. The patients will suffer from low levels of insulin which functions as a component for the regulation of body sugar (Feinglos, 2008). The number of islets of Langerhans in the pancreas is normal or somewhat reduced. It is mostly characterized by hyperglycemia that is associated with the insufficient or dysfunctional insulin present in the body (Thomas, 2013). Abnormal coagulation, hypertension and diabetic dyslipidemia are also commonly reported to signify the occurrence of type II diabetes mellitus. The increased number of obesity cases has seen the diagnosis of diabetes mellitus type II in teenagers and young adults (Feinglos, 2008). In cases when the patient is not obese, there is a presence of high fat distribution in the body (Feinglos, 2008).
People suffering from Type II diabetes mellitus, unlike type I diabetes, do not need regular injections of insulin (Thomas, 2013). The management of type II diabetes involves the control of the increased levels of blood sugar. It is, however, important to note that the reduction of the sugar levels should not surpass the normal blood sugar levels.
Because most of the patients are overweight, exercise, a proper balanced diet and reduction of weight is fundamental in the management of type II diabetes mellitus (Feinglos, 2008).
Pioglitazone is a drug belonging to a class of thiazolidinediones and is used in the management and of type II diabetes mellitus (Schatz, 2000). Since the body is unable to control the increasing levels of sugar in the blood, pioglitazone is used to increase the sensitivity to insulin (Feinglos, 2008). The drug, however, does not cure the diabetes mellitus but only helps the body in maintaining normal blood sugar levels. It is an oral formulation and can be taken twice daily with or without taking meals (Schatz, 2000). It is able to achieve this by inhibiting the hepatic gluconeogenesis process and also increase peripheral and splanchnic glucose uptake which implies that there is a minimal occurrence of increased blood sugar levels (Feinglos, 2008). It effects can be seen in the short term and also in the long-term (Schatz, 2000). The use of pioglitazone can be done according to the doctor’s prescription. It also important to inform the doctor before stopping the use or if any complications arise while using pioglitazone.The development of pioglitazone is based on the discovery of gene SOCS3 (Suppressor of Cytokine Signaling-3) (Schatz, 2000). The elevation of the gene causes interferon resistance that in turn causes insulin resistance in the liver. Depletion of this gene has been made possible by pioglitazone which results in the reduced insulin resistance in the liver although it may cause systemic insulin resistance (Schatz, 2000). The suppression of gene SOCS3 by pioglitazone gives it the antiglycemic and ant diabetic property hence it has bee used in the management of the two cases.
Thomas, M. (2013). Understanding type 2 diabetes: Fewer highs fewer lows better health. Wollombi, N.S.W: Exisle Publishing.
Feinglos, M. N., & Bethel, M. A. (2008). Type 2 diabetes mellitus: An evidence-based approach to practical management. Totowa, NJ: Humana Press.
Schatz, H. (2000). Pioglitazone: From discovery to clinical practice. Heidelberg: Barth