A medication given to diabetics to improve their body's sensitivity to insulin also appears to slow the thickening of their artery walls, according to a study posted online by JAMA: The Journal of the American Medical Association.
The study is being released early to coincide with its presentation at the American Heart Association Scientific Session. It will be published in the December 6 print issue of JAMA.
Individuals with diabetes, who cannot produce sufficient amounts of insulin or respond to the insulin needed to turn glucose into energy, have a higher risk for myocardial infarction (heart attack), according to background information in the article. Controlling blood pressure and low-density lipoprotein (LDL, or "bad") cholesterol has been shown to reduce some of this excess risk. "However, even with optimal control of these potent cardiovascular risk factors, incremental risk for cardiovascular events remains high compared with individuals without diabetes," the authors write. "New approaches are, therefore, needed to further reduce cardiovascular risk in patients with diabetes."
Theodore Mazzone, M.D., of the University of Illinois at Chicago College of Medicine, and colleagues studied the effects of a potential new approach, using a drug known as pioglitazone, in 462 adults with type 2 diabetes in the Chicago metropolitan area between 2003 and 2006. Study participants had an average age of 60 and included 289 men and 173 women; they were randomly assigned to receive a daily dose of either pioglitazone (15 to 45 milligrams) or of glimepiride (1 to 4 milligrams), another diabetes medication that works through different mechanisms. At the beginning of the study and again 24, 48 and 72 weeks later, ultrasound was used to measure the thickness of the middle layers of the carotid arteries (which are located in the neck and carry blood to the brain). The measurements are called carotid artery intima-media thickness, or CIMT. Using this measurement, other studies have suggested that thicker artery walls, and changes in artery wall thickness over time, are associated with a higher risk for heart events. Glycosolated hemoglobin (HbA1c) levels, a measure of blood glucose control over an extended period, were also monitored throughout the study, as were blood pressure, blood cholesterol levels and adverse events.