Cochrane · systematic review · CD013516
Pioglitazone for prevention or delay of type 2 diabetes mellitus and its associated complications in people at risk for the development of type 2 diabetes mellitus
Ipsen, EØ, Madsen, KS, Chi, Y, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Metabolic and Endocrine DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
35
current version
GRADE rated
16
No studies
18
Included studies
NR
No studies 18 · 51.4%Ungraded 1 · 2.9%Very low 7 · 20%Low 8 · 22.9%Moderate 1 · 2.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings: pioglitazone monotherapy versus another pharmacological glucose‐lowering monotherapy
Population: people at increased risk of developing T2DM
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | NR | No studies |
Metformin Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | NR | No studies |
Acarbose Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | NR | No studies |
Repaglinide Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | NR | No studies |
Incidence of T2DM (N) Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | 2 participants | Ungraded |
Metformin Diagnostic criteria: 2 studies applied the WHO 1999 criteria for 'prediabetes' (FPG > 6.1 mmol/L and < 7.0 mmol/L and/or a 2‐h glucose < 11.1 mmol/L after a 75 g OGTT; Chen 2007a; Zeng 2013) Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | RR 0.98 [0.4, 2.38] | 3 studies · 331 participants | Low Downgraded: imprecision |
Acarbose Diagnostic criteria: 1 study applied the WHO 1999 criteria for prediabetes (FPG > 6.1 mmol/L and < 7.0 mmol/L and/or a 2‐h glucose < 11.1 mmol/L after a 75 g OGTT; Chen 2007a) Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | 1 study · 96 participants | Very low Downgraded: risk of bias, imprecision |
Repaglinide Diagnostic criteria: 1 study applied the ADA 2010 criteria (FPG ≥ 5.6 mmol/L and < 6.9 mmol/L and 2‐h glucose ≥ 7.8 mmol/L or < 11.0 mmol/L after a 75 g OGTT; Zhang 2007) Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | 1 study · 96 participants | Low Downgraded: imprecision |
Serious adverse events (N) Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | NR | No studies |
Metformin Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | 2 studies · 201 participants | Low Downgraded: imprecision |
Acarbose Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | 1 study · 96 participants | Very low Downgraded: risk of bias, imprecision |
Repaglinide Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | 1 study · 103 participants | Low Downgraded: imprecision |
Cardiovascular mortality Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | NR | No studies |
Socioeconomic effects Summary of findings: pioglitazone monotherapy vs another pharmacological glucose‐lowering monotherapy | no estimate extracted | NR | No studies |
Summary of findings: pioglitazone monotherapy versus intensive behaviour‐changing intervention
Population: people at increased risk for developing T2DM
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Summary of findings: pioglitazone monotherapy vs intensive behaviour‐changing intervention | no estimate extracted | NR | No studies |
Incidence of T2DM (N) Summary of findings: pioglitazone monotherapy vs intensive behaviour‐changing intervention | no estimate extracted | 1 study · 96 participants | Low Downgraded: imprecision |
Serious adverse events (N) Summary of findings: pioglitazone monotherapy vs intensive behaviour‐changing intervention | no estimate extracted | 1 study · 103 participants | Low Downgraded: imprecision |
Cardiovascular mortality Summary of findings: pioglitazone monotherapy vs intensive behaviour‐changing intervention | no estimate extracted | NR | No studies |
Non‐fatal myocardial infarction/stroke Summary of findings: pioglitazone monotherapy vs intensive behaviour‐changing intervention | no estimate extracted | NR | No studies |
Health‐related quality of life Summary of findings: pioglitazone monotherapy vs intensive behaviour‐changing intervention | no estimate extracted | NR | No studies |
Socioeconomic effects Summary of findings: pioglitazone monotherapy vs intensive behaviour‐changing intervention | no estimate extracted | NR | No studies |
Summary of findings: pioglitazone monotherapy versus placebo
Population: people at increased risk for developing T2DM
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality (N) Summary of findings: pioglitazone monotherapy vs placebo | 2.38 [0.54, 10.5] | 4 studies · 1156 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Incidence of T2DM (N) Diagnostic criteria: 3 studies applied the WHO 1999 criteria for 'prediabetes' (FPG > 6.1 mmol/L and < 7.0 mmol/L and/or a 2‐h glucose < 11.1 mmol/L after a 75 g OGTT; Attallah 2007; IDPP‐2; Xu 2011) Summary of findings: pioglitazone monotherapy vs placebo | RR 0.4 [0.17, 0.95] | 6 studies · 1395 participants | Low Downgraded: risk of bias, imprecision |
Serious adverse events (N) Summary of findings: pioglitazone monotherapy vs placebo | 3 [0.32, 28.22] | 2 studies · 187 participants | Very low Downgraded: risk of bias, imprecision |
Cardiovascular mortality (N) Summary of findings: pioglitazone monotherapy vs placebo | RR 5.14 [0.25, 106.28] | 4 studies · 1156 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Non‐fatal myocardial infarction/stroke (N) Summary of findings: pioglitazone monotherapy vs placebo | RR 1.97 [0.18, 21.65] | 3 studies · 789 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Health‐related quality of life Summary of findings: pioglitazone monotherapy vs placebo | no estimate extracted | NR | No studies |
Socioeconomic effects Summary of findings: pioglitazone monotherapy vs placebo | no estimate extracted | NR | No studies |
Summary of findings: pioglitazone monotherapy versus no intervention
Population: people at increased risk of developing T2DM
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality (N) Summary of findings: pioglitazone monotherapy vs no intervention | RR 0.85 [0.38, 1.91] | 3 studies · 866 participants | Very low Downgraded: imprecision, indirectness |
Incidence of T2DM (N) Diagnostic criteria: 9 studies applied the WHO 1999 criteria for 'prediabetes' (FPG > 6.1 mmol/L and < 7.0 mmol/L and/or a 2‐h glucose < 11.1 mmol/L after a 75 g OGTT; Che 2014; Chen 2007a; Gao 2011; Ke 2006; Liang 2004; Xiu ... Summary of findings: pioglitazone monotherapy vs no intervention | RR 0.31 [0.23, 0.4] | 16 studies · 2053 participants | Moderate Downgraded: risk of bias, imprecision |
Serious adverse events (N) Summary of findings: pioglitazone monotherapy vs no intervention | RR 0.71 [0.38, 1.32] | 7 studies · 1211 participants | Low Downgraded: imprecision |
Cardiovascular mortality Summary of findings: pioglitazone monotherapy vs no intervention | no estimate extracted | NR | No studies |
Non‐fatal myocardial infarction/stroke Summary of findings: pioglitazone monotherapy vs no intervention | no estimate extracted | NR | No studies |
Health‐related quality of life Summary of findings: pioglitazone monotherapy vs no intervention | no estimate extracted | NR | No studies |
Socioeconomic effects Summary of findings: pioglitazone monotherapy vs no intervention | no estimate extracted | NR | No studies |