Pioglitazone: From development to clinical practice

In the 1960s and 1970s, the worldwide search for new lipid-lowering and ant ihyperglycaemic therapies intensified, nle goal was to find new treatments that would act differently from the fibrates. During this time, the pathoge nesis of insulin resistance was further explored. Takeda Research Laborator ies developed respective new diabetic animal models, which resulted in the synthesis of the first insulin sensitisers. Pioglitazone, a member of the t hiazolidinedione class, was identified in the early 1980s as a compound tha t was able to reduce hyperglycaemia and also hyperlipidaemia. Pioglitazone requires insulin for its action, and its mechanism of action distinctly dif fers from that of other classes of oral antidiabetic drugs. Although the fu ll mechanism of action of thiazolidinediones is not yet completely understo od, their recent introduction represents the: first opportunity to specific ally treat a main underlying disease factor in type 2 diabetes: insulin res istance. This supplement summarizes some of the recent scientific evidence with pioglitazone and its use in everyday clinical management of patients w ith type 2 diabetes.