I have anecdotal experience with pioglitazone in this setting, especially if the patient will be taking concomitant corticosteroids for a sustained period of time. Pioglitazone offers modest reduction of SBP, reduces insulin resistance, and aids in control of blood glucose secondary to corticosteroids. In an adult, start with 15 mg once daily, titrate up to glucose response and/or hypoglycemia.

Dear Kenneth

Corticosteroids are contraindicated in TBI as they resulted in worsening of outcomes in recent studies

It s a guideline according to evidence based data