Abstract
The effect of troglitazone on the proinsulin level in patients with type 2 diabetes mellitus was assessed. Twelve patients received troglitazone 400 mg/d and 10 received gliclazide 40 mg/d for 12 weeks. Nine of the 12 patients receiving troglitazone also received concomitant sulfonylurea treatment. Fasting blood samples were collected before and after treatment. The fasting plasma glucose, glycosylated hemoglobin A 1c (Hb A 1c), and immunoreactive insulin decreased significantly after troglitazone therapy. Proinsulin levels (from 32.6 ± 4.5 to 17.6 ± 3.1 pmol/L; P < 0.01) also decreased significantly after troglitazone therapy. A significant correlation (r = .674, P < 0.05) was observed between the changes in proinsulin level and Hb A 1c in patients receiving troglitazone. After treatment with gliclazide, the fasting plasma glucose and Hb A 1c levels decreased significantly; however, no change was observed in the immunoreactive insulin or proinsulin level. Results of this study suggest that proinsulin levels can be reduced by improvement of glycemic control using troglitazone and may lead to the preservation of pancreatic islet cell function in patients with type 2 diabetes mellitus.
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