Scientists have long known that insulin resistance, which happens when the body’s cells do not respond normally to insulin, increases risk for stroke and heart attack and the new study shows the benefits associated with using drugs for insulin resistance in preventing these incidences.
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The diabetes drug pioglitazone (Actos) works by addressing the body’s insulin resistance.
For the study, Kernan and colleagues assigned almost 4,000 patients who had suffered a stroke or a mini-stroke to Actos or a placebo.
The team recruited 3,876 participants from seven countries who had recently suffered from an ischemic stroke or transient ischemic attack.
Over a period of five years, nine per cent of the Actos group had a second stroke, compared to 12 per cent of the placebo group.
Insulin resistant patients who took pioglitazone had a reduced risk of developing type 2 diabetes. They all had a recent history of ischemic stroke or transient ischemic attack.
In other results, pioglitazone was linked with a greater frequency of weight gain greater than 4.5 kg compared with placebo (52.2% vs. 33.7%; P .001). Find us on Facebook too!
Relative to the study, Koroshetz said activities like exercise and dieting, commonly advised to diabetics to prevent weight gain, should be given more vascular studies on how else it would help abate the recurrence of stroke and heart attack. The study was also scheduled to be presented Wednesday at the American Stroke Association’s annual meeting, in Los Angeles.
“After years of controversy, pioglitazone is now proven to have cardiovascular benefits, ” says Dr. Silvio Inzucchi, the principal endocrinologist for the IRIS Trial.
In a related editorial published in The New England Journal of Medicine, Clay F. Semenkovich, MD, from the division of endocrinology, metabolism and lipid research at Washington University in St. Louis, noted that “while the results of the IRIS trial might tempt clinicians to rush to prescribe pioglitazone”, he urged caution because the positive outcomes may have been related to the design of the trial. To help doctors and patients choose the best strategy for preventing recurring strokes, future studies will attempt to identify a person’s risk of bone fractures due to pioglitazone. The drug, for instance, was found to increase risk of bone fracture that requires either hospitalization or surgery. The mission of NINDS is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.
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The U.S. National Institutes of Health provided funding for the study. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases.
