Acarbose or pioglitazone which will be more effective for diabete
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http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/DiabetesUpdate-FINAL-Feb09.pdf
acarboze gives side-effects among carbo diet patients - as an additonal drug pioglitazone should be more effective -obviously it is my subjective opinion. Piotr dziemidok
Acarbose is useful for treating post prandial hyperglycemia. It has got gastrointestinal side effect. Pioglitazone is a unique antidiabetic drug with antiatherosclerotic property. Only concern of pioglitazone is increased incidence of bladder cancer and sodium retention. It not not be used in patients of heart failure or reduced ejection fraction. In low dose 7.5mg/day pioglitazone is effective as oral hypoglycemic agent with very little chance of bladder cancer. Both drugs usually do not cause hypoglycemia. In my personal experience pioglitazone is better in terms of sugar and HbA1c controll.. I think it is a underrated drug.. Very cheap and effective.. Further large trial required...
Hello Biswajit Majumder
How safe is the use of thiazolidinediones (TZDs) in clinical practice?
As you mentioned, the FDA said today that an increased risk of bladder cancer due to pioglitazone cannot be ruled out.Other TZDs such as rosiglitazone side effects are heart failure, edema and chest pain. It seems that glitazones administration in patients suffering from NIDDM need precise follow up. Sitagliptin along with diet and exercise is useful for treating post prandial hyperglycemia.
Dear Sayed. ..Definitely bladder cancer is a concern with pioglitazone. But pioglitazone has got some unique benefit among the oral hypoglycemic agents.. Like antiatherosclerotic property and it can prevent stroke. Emphagliflozin has also showed cardiovascular mortality benefit. So combination of pioglitazone and Emphagliflozin can have an additive benefit in terms of cardiovascular mortality theoretically. Some study needed with these combination. Wheather 7.5mg/d pioglitazone have got bladder cancer risk that should also be evaluated. Some well designed study required to get all these answars..Pioglitazone should not be used just as a route oral hypoglycemic agents to get the benefit of sugar lowering.. But can be used to get the cardiovascular and stroke prevention benefits in high risk patients with close monitoring for bladder cancer by relevant investigation.. Thanks..
Dr Majumder I am diabetic for last 17 years. I have used both the medicines for long days. In my experience Pioglitazone is much better drug in terms of controlling sugar and lowering HbA1C. Acarbose causes flatulence. If patient is not older or no risk of CCF or water retention I think Pioglitazone is better. So far bladder cancer is concerned patient could be monitored for that carefully rather than banning it. In a certain dosage and using for less that two years it has no harm . So it can be used is 'switch off' and 'on' pattern.[stopping after two years and again restarting after one year] . Of course I have data in my hand . This is a potential possibility.
Arcabose is alpha-glucosidase (digestive enzyme) inhibitor, while pioglitazone is a PPAR(gamma) agonist. Both of them have undesirable side effects. I would suggest considering dipeptidyl peptidase 4 inhibitor, like Sitagliptin or glucose reabsorption inhibitor, like Canagliflozin.
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