Pioglitazone HCl appears to protect against nerve-related disorders and blood vessel function by reducing inflammation and increasing peripheral insulin sensitivity. The findings showed patients taking pioglitazone demonstrated significant improvement in microvascular function, while maintaining better blood glucose control and enhanced insulin sensitivity.

An estimated 85,000 amputations occur in the United States each year, and the majority are diabetes-related. Six out of every 1,000 people with diabetes undergo amputation due to severe nerve damage and poor blood vessel function that is caused by a build up of free radicals in the body like nitrogen and oxygen. According to the American Diabetes Association, the risk of a lower-level leg amputation is 15-40 times greater for a person with diabetes. U.S. costs associated with limb amputation are estimated to be about $37 billion per year.

"We are encouraged by the potential impact pioglitazone may have on neuropathy -- one of the most costly diabetes-related complications on both a financial and emotional level," said Aaron I. Vinik, of the Eastern Virginia Medical School and one of the study's investigators. "Ask a person with diabetes which disease-related complications they fear most and losing a limb is at top of the list every time."

The study's goal was to determine the effect of short-term treatment with pioglitazone, an insulin sensitizer belonging to the thiazolidinedione (TZD) class of oral anti-diabetic agents, would have on peripheral skin perfusion and nitric oxide. Skin perfusion was measured using laser Doppler techniques in response to skin warming and nitric oxide production was determined using a meter inserted directly into the skin. Eleven people with type 2 diabetes participated in the 12-week, double-blind, placebo-controlled clinical study, followed by 12 weeks of open label treatment with pioglitazone (45 mg).

Study participants underwent measurements prior to beginning pioglitazone and then at 6-week intervals during both treatment phases. Findings revealed that skin perfusion in response to skin warming increased from 179.24 to 268.51 after taking pioglitazone. Nitric oxide production also was decreased significantly after pioglitazone therapy, both in basal condition before skin warming and after heat stimulation. Investigators concluded that pioglitazone's ability to enhance peripheral insulin sensitivity also benefits the body's nerve and blood vessel function and reduces inflammation.