To the content
2 . 2022

Benefits for pioglitazone in prevention and treatment of type 2 diabetes mellitus and its complications


The article reflects the main ideas about the effects of the thiazolidinediones group drug pioglitazone, its place in the modern view on the treatment of type 2 diabetes mellitus. The possibilities of its combination with alogliptin, the inhibitors of dipeptidyl peptidase 4 group drug, as well as the advantages of using a fixed combination of the drug, are highlighted. These groups of drugs have different points of application of action, which enhances the hypoglycemic effect without the risk of hypoglycemia.

Keywords:thiazolidinediones; pioglitazone; inhibitors of dipeptidyl peptidase 4; alogliptin; type 2 diabetes mellitus; combination therapy

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Ametov А.S., Pyanykh O.P., Vovk P.S. Benefits for pioglitazone in prevention and treatment of type 2 diabetes mellitus and its complications. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (2): 56–63. DOI: (in Russian)


1. Schernthaner G., Currie C.J., Schernthaner G.-H. Do we still need pioglitazone for the treatment of type 2 diabetes? A risk-benefit critique in 2013. Diabetes Care. 2013; 36 (Suppl 2): S 155-61. DOI: 13-2031

2. Perdigoto A.L., Young L.H., Inzucchi S.E. Pioglitazone and cardiovascular risk reduction: time for a second look? Cardiovasc Endocrinol. 2017; 6 (2): 55-61. DOI:

3. Eldor R., DeFronzo R.A., Abdul-Ghani M. In vivo actions of peroxisome proliferator-activated receptors: glycemic control, insulin sensitivity, and insulin secretion. Diabetes Care. 2013; 36 (Suppl 2): S162-74. DOI:

4. Ryder R.E., Defronzo R.A. Rehabilitation of pioglitazone: 2. Br J Diabetes. 2015; 15 (2): 46-9. DOI:

5. Nesti L., Tricò D., Mengozzi A., Natali A. Rethinking pioglitazone as a cardioprotective agent: a new perspective on an overlooked drug. Cardiovasc Diabetol. 2021; 20 (1): 109. DOI:

6. Triplitt C., Cersosimo E., DeFronzo R.A. Pioglitazone and alogliptin combination therapy in type 2 diabetes: a pathophysiologically sound treatment. Vasc Health Risk Manag. 2010; 6: 671-90. DOI:

7. DeFronzo R.A., Inzucchi S., Abdul-Ghani M., Nissen S.E., et al. Pioglitazone: the forgotten, cost-effective cardioprotective drug for type 2 diabetes. Diab Vasc Dis Res. 2019; 16 (2): 133-43. DOI:

8. Ahn C.H., Lim S. Effects of thiazolidinedione and new antidiabetic agents on stroke. J Stroke. 2019; 21 (2): 139-50.

9. Di Pino A., DeFronzo R.A. Insulin resistance and atherosclerosis: implications for insulin-sensitizing agents. Endocr Rev. 2019; 40 (6): 1447-67.

10. Ryder R.E.J., DeFronzo R.A. Diabetes medications with cardiovascular protection as we enter a new decade: can SGLT2 inhibitors, long-acting GLP-1 receptor agonists, pioglitazone and metformin complement each other to save lives? 1. Br J Diabetes. 2020; 20 (1): 5-8.

11. DeFronzo R.A., Chilton R., Norton L., Clarke G., et al. Revitalization of pioglitazone: the optimum agent to be combined with a sodium-glucose co-transporter-2 inhibitor. Diabetes Obes Metab. 2016; 18 (5): 454-62. DOI:

12. Sumida Y., Yoneda M., Tokushige K., Kawanaka M., et al. Antidiabetic therapy in the treatment of nonalcoholic steatohepatitis. Int J Mol Sci. 2020; 21 (6): 1907. DOI:

13. Cusi K., Orsak B., Bril F., Lomonaco R., et al. Long-term pioglitazone treatment for patients with nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus: a randomized trial. Ann Intern Med. 2016; 165 (5): 305-15. DOI:

14. Nesto R.W., Bell D., Bonow R.O., Fonseca V., et al. Thiazolidinedione use, fluid retention, and congestive heart failure: a consensus statement from the American Heart Association and American Diabetes Association. Diabetes Care. 2004; 27 (1): 256-63. DOI:

15. Satirapoj B., Watanakijthavonkul K., Supasyndh O. Safety and efficacy of low dose pioglitazone compared with standard dose pioglitazone in type 2 diabetes with chronic kidney disease: a randomized controlled trial. PLoS One. 2018; 13 (10): e0206722. DOI:

16. Tomlinson B., Chan P., Lam C.W.K. An overview of alogliptin + pioglitazone for the treatment of type 2 diabetes. Expert Opin Pharmacother. 2022; 23 (1): 29-42. DOI:

17. Rosenstock J., Inzucchi S.E., Seufert J., Fleck P.R., et al. Initial combination therapy with alogliptin and pioglitazone in drug-naïve patients with type 2 diabetes. Diabetes Care. 2010; 33 (11): 2406-8. DOI:

18. DeFronzo R.A., Burant C.F., Fleck P., Wilson C., et al. Efficacy and tolerability of the DPP-4 inhibitor alogliptin combined with pioglitazone, in metformin-treated patients with type 2 diabetes. J Clin Endocrinol Metab. 2012; 97 (5): 1615-22. DOI:

19. Kim J.M., Kim S.S., Kim J.H., et al. Efficacy and safety of pioglitazone versus glimepiride after metformin and alogliptin combination therapy: A randomized, open-label, multicenter, parallel-controlled study. Diabetes Metab J. 2020; 44 (1): 67-77. DOI:

20. Van Raalte D.H., van Genugten R.E., Eliasson B., et al. The effect of alogliptin and pioglitazone combination therapy on various aspects of β-cell function in patients with recent-onset type 2 diabetes. Eur J Endocrinol. 2014; 170 (4): 565-74. DOI:

21. Eliasson B., Möller-Goede D., Eeg-Olofsson K., et al. Lowering of postprandial lipids in individuals with type 2 diabetes treated with alogliptin and/or pioglitazone: a randomised double-blind placebo-controlled study. Diabetologia. 2012; 55 (4): 915-25. DOI:

Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
Medicine today

Уважаемые коллеги, до XI-го Национального конгресса с международным участием имени Н.О. Миланова "Пластическая хирургия, эстетическая медицина и косметология" осталось 3 дня! С 29 ноября по 1 декабря 2022 года в Москве пройдет XI Национальный конгресс "Пластическая хирургия,...

6-7 декабря 2022 года состоится юбилейная X конференция с международным участием "Креативная кардиология и кардиохирургия. Новые технологии диагностики и лечения заболеваний сердца", которая будет проходить в очном и онлайн-формате в ФГБУ "НМИЦ ССХ им. А.Н. Бакулева"...

Приглашаем 1 и 2 декабря в Москву на яркий профессиональный праздник - итоговую всероссийскую Школу РОАГ! Школа в Москве занимает особое место в образовательном цикле Школ РОАГ. На ней подводятся итоги прошедшего сезона, обсуждаются темы, которые вызывают наибольший интерес...

Journals of «GEOTAR-Media»