***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The goal of this study was to compare the effects of 2 doses of pioglitazone hydrochloride ( a thiazolidinedione insulin sensitizer ) with placebo on glycated hemoglobin ( HbA(1c ) ) , insulin sensitivity , and lipid profiles in patients with type 2 diabetes mellitus who had suboptimal glycemic control and mild dyslipidemia . METHODS Patients with type 2 diabetes mellitus ( HbA(1c ) > /=6.5 % and < /=9.8 % ) who had not previously received insulin or oral antihyperglycemic medications ( OAMs ) were r and omized to treatment with placebo , pioglitazone 30 mg QD , or pioglitazone 45 mg QD in double-blind fashion for 16 weeks at 41 centers in Canada and Spain . RESULTS A total of 297 patients were r and omized ( 99 in each group ) . Overall , 286 ( 96.3 % ) were white . Mean ( SD ) age was 58.4 ( 10.9 ) years ( range , 24 - 85 years ) , mean ( SD ) body mass index was 31.4 ( 4.8 ) kg/m(2 ) , mean ( SD ) duration of type 2 diabetes mellitus was 20.0 ( 37.4 ) months , and 30.6 % of patients were receiving medication for dyslipidemia . Treatment with pioglitazone 30 or 45 mg QD for 16 weeks reduced mean HbA(1c ) by 0.8 % and 0.9 % from baseline , respectively ( both P < 0.001 vs baseline and placebo ) . A reduction in HbA(1c ) of 0.2 % was observed in the placebo group ( P = 0.025 ) . In patients with medium ( > /=7 % to < 8 % ) or high ( > /=8 % to < /=9.8 % ) baseline HbA(1c ) , both doses of pioglitazone significantly reduced HbA(1c ) ( both P < 0.001 vs placebo ) . Pioglitazone 30 and 45 mg significantly reduced fasting serum insulin versus placebo ( P = 0.008 and P = 0.006 , respectively ) and increased insulin sensitivity by Homeostasis Model Assessment versus placebo ( P = 0.039 and P = 0.001 , respectively ) . Relative to placebo , pioglitazone 30 and 45 mg significantly increased high-density lipoprotein cholesterol ( HDL-C [ P = 0.028 and P < 0.001 , respectively ] ) and lowered the atherogenic index of plasma ( P = 0.018 and P < 0.001 , respectively ) . Pioglitazone 45 mg also significantly reduced serum triglycerides , apolipoprotein B , and total cholesterol : HDL-C ratio versus placebo ( P = 0.007 , P = 0.015 , and P = 0.005 , respectively ) . Pioglitazone 30 and 45 mg were associated with a significant reduction in serum alanine aminotransferase relative to placebo ( P = 0.036 and P = 0.005 , respectively ) . Pioglitazone appeared to be safe and was well tolerated . CONCLUSIONS In the present study , pioglitazone 30 and 45 mg produced significant improvements in HbA(1c ) , insulin sensitivity , and lipid profile in OAM-naive patients with type 2 diabetes mellitus with suboptimal glycemic control and mild dyslipidemia OBJECTIVE To determine the efficacy of rosiglitazone compared with placebo in reducing hyperglycemia . RESEARCH DESIGN AND METHODS After a 4-week placebo run-in period , 959 patients were r and omized to placebo or rosiglitazone ( total daily dose 4 or 8 mg ) for 26 weeks . The primary measure of efficacy was change in the HbA1c concentration . RESULTS Rosiglitazone produced dosage-dependent reductions in HbA1c of 0.8 , 0.9 , 1.1 , and 1.5 % in the 4 mg o.d . , 2 mg b.i.d . , 8 mg o.d . , and 4 mg b.i.d . groups , respectively , compared with placebo . Clinical ly significant decreases from baseline in HbA1c were observed in drug-naive patients at all rosiglitazone doses and in patients previously treated with oral monotherapy at rosiglitazone 8 mg o.d . and 4 mg b.i.d . Clinical ly significant decreases from baseline in HbA1c were also observed with rosiglitazone 4 mg b.i.d . in patients previously treated with combination oral therapy . Approximately 33 % of drug-naive patients treated with rosiglitazone achieved HbA1c < or = 7 % at study end . The proportions of patients with at least one adverse event were comparable among the rosiglitazone and placebo groups . There was no evidence of hepatotoxicity in any treatment group . There were statistically significant increases in weight and serum lipids in all rosiglitazone treatment groups compared with placebo . For LDL and HDL cholesterol , the observed increase appeared to be dose related . CONCLUSIONS Rosiglitazone at total daily doses of 4 and 8 mg significantly improved glycemic control in patients with type 2 diabetes and was well tolerated This study examines the effect of rosiglitazone on urinary albumin excretion ( UAE ) in patients with type II diabetes .  Urinary albumin : creatinine ratio ( ACR ) was measured in a 52-week , open-label , cardiac safety study comparing rosiglitazone and glyburide .  Patients were r and omised to treatment with rosiglitazone 4 mg b.i.d . or glyburide .  ACR was measured at baseline and after 28 and 52 weeks of treatment . Statistically significant reductions from baseline in ACR were observed in both treatment groups at week 28 . By week 52 , only the rosiglitazone group showed a significant reduction from baseline . Similar results were observed for the overall study population and for the subset of patients with baseline microalbuminuria . For patients with microalbuminuria at baseline , reductions in ACR did not correlate strongly with reductions in glycosylated haemoglobin , or fasting plasma glucose , but showed strong correlation with changes in mean 24-h systolic and diastolic blood pressure  for rosiglitazone-treated patients ( ΔACR vs Δmean 24-h systolic blood pressure , r=0.875 ; ΔACR vs Δmean 24-h diastolic blood pressure , r=0.755 ; P<0.05 for both ) . No such correlation was observed for glyburide-treated patients . In conclusion , rosiglitazone treatment was associated with a decrease in urinary albumin excretion . These findings suggest a potential beneficial effect of rosiglitazone in the treatment or prevention of renal and vascular complications of type II diabetes PURPOSE To evaluate the efficacy and tolerability of pioglitazone in combination with a sulfonylurea in the treatment of type 2 diabetes mellitus . SUBJECTS AND METHODS This 16-week , double-blind study included patients on a stable regimen of a sulfonylurea for > or = 30 days and with a glycosylated hemoglobin ( HbA1C ) level > or = 8.0 % . Patients were r and omly assigned to receive once daily  pioglitazone 15 mg ( n = 184 ) , pioglitazone 30 mg  ( n = 189 ) , or placebo plus sulfonylurea  ( n = 187 ) . RESULTS Patients receiving pioglitazone + sulfonylurea had significant ( P < 0.05 ) decreases from baseline in HbA1C and fasting plasma glucose levels compared with patients treated with placebo + sulfonylurea . As compared with placebo , HbA1C decreased by 0.9 % ( 95 % confidence interval [ CI ] : 0.06 % to 1.2 % ) with pioglitazone 15 mg and 1.3 % ( CI : 1 % to 1.6 % ) with 30 mg pioglitazone ; fasting plasma glucose levels decreased by 39 mg/dL ( 95 % CI : 27 to 52 mg/dL ) with pioglitazone 15 mg and by 58 mg/dL ( 95 % CI : 46 - 70 mg/dL ) with 30 mg pioglitazone . Both pioglitazone + sulfonylurea groups had significant ( P < 0.05 ) mean percent decreases in triglyceride levels ( 17 % , 95 % CI : 6 % to 27 % for 15 mg ; 26 % , 95 % CI : 16 % to 36 % for 30 mg ) and increases in high-density lipoprotein cholesterol levels ( 6 % , 95 % CI : 1 % to 11 % for 15 mg ; 13 % , CI : 8 % to 18 % for 30 mg ) compared with placebo + sulfonylurea . There were small but statistically significant mean percent increases in low-density lipoprotein cholesterol levels in all groups . Pioglitazone was well tolerated , and the rates of adverse events were similar in all groups . CONCLUSION In patients with type 2 diabetes , pioglitazone plus sulfonylurea significantly improves HbA1C and fasting plasma glucose levels with beneficial effects on serum triglyceride and HDL-cholesterol levels Background : There is growing evidence in animal and in vitro studies showing that thiazolidinediones ( TZDs ) improve pancreatic beta cell ( β‐cell ) function . The aim of this study was to evaluate the effect of thiazolidinediones on the β‐cell function of patients with Type 2 diabetes mellitus ( T2DM ) in clinical practice Pioglitazone , a thiazolidinedione , improves glycemic control primarily by increasing peripheral insulin sensitivity in patients with type 2 diabetes , whereas metformin , a biguanide , exerts its effect primarily by decreasing hepatic glucose output . In the first head-to-head , double-blind clinical trial comparing these two oral antihyperglycemic medications ( OAMs ) , we studied the effect of 32-wk monotherapy on glycemic control and insulin sensitivity in 205 patients with recently diagnosed type 2 diabetes who were naive to OAM therapy . Subjects were r and omized to either 30 mg pioglitazone or 850 mg metformin daily with titrations upward to 45 mg ( 77 % of pioglitazone patients ) and 2550 mg ( 73 % of metformin patients ) , as indicated , to achieve fasting plasma glucose levels of less than 7.0 mmol/liter ( 126 mg/dl ) . Pioglitazone was comparable to metformin in improving glycemic control as measured by hemoglobin A1C and fasting plasma glucose . At endpoint , pioglitazone was significantly more effective than metformin in improving indicators of insulin sensitivity , as determined by reduction of fasting serum insulin ( P = 0.003 ) and by analysis of homeostasis model assessment for insulin sensitivity ( HOMA-S ; P = 0.002 ) . Both OAM therapies were well tolerated . Therefore , pioglitazone and metformin are equally efficacious in regard to glycemic control , but they exert significantly different effects on insulin sensitivity due to differing mechanisms of action . The more pronounced improvement in indicators of insulin sensitivity by pioglitazone , as compared with metformin monotherapy in patients recently diagnosed with type 2 diabetes who are OAM-naive , may be of interest for further clinical evaluation OBJECTIVES We sought to assess the effect of rosiglitazone on markers of endothelial cell activation and acute-phase reactants in non-diabetic patients with coronary artery disease ( CAD ) . BACKGROUND Inflammation plays a key role in all stages of atherosclerosis and in the genesis of acute coronary syndromes . Rosiglitazone , a peroxisome proliferator-activated receptor gamma agonist , is used in the treatment of type 2 diabetes mellitus , and previous data suggest that it may have anti-inflammatory effects on atherosclerosis . METHODS Patients with stable , angiographically documented CAD without diabetes mellitus were investigated . Patients were r and omized in a double-blind manner to receive treatment with placebo or rosiglitazone ( 4 mg/day for 8 weeks followed by 8 mg/day for 4 weeks ) for 12 weeks . Eighty-four patients completed the study .  Fasting glucose , insulin , lipid profile , markers of endothelial activation , and inflammatory markers were measured at baseline and after 12 weeks . RESULTS Rosiglitazone treatment result ed in a significant reduction in E-selectin ( p = 0.03 ) , von Willebr and factor ( p = 0.0 
    Output:
    
Effects can be seen in as little as 4 weeks , but full lowering takes 6 to 12 weeks .
When used in combination with other diabetic agents , such as sulfonylureas and biguanides , TZDs ' hypoglycemic effects appear to be complementary .
Thiazolidinediones directly improve insulin sensitivity and recovery of pancreatic beta cell function .
Nevertheless , there is no evidence indicating that TZDs are superior to other antidiabetic agents currently available or that TZDs reduce the long-term complications of DM2 .