The efficacy of an insulin-response drug following stroke

This study tested whether pioglitazone (Actos), a drug that increases the body’s response to insulin, is effective at reducing the chance of vascular disease patients following stroke. Researchers determined that while treating stroke patients with pioglitazone decreased there risk of vascular disease and diabetes, there were adverse side effects.

Insulin is a hormone in the body involved in regulating blood sugar levels. Resistance to insulin, where the body no longer responds to insulin, is common following stroke. Insulin resistence can influence the risk of cardiovascular disease (diseases involving the heart or blood vessels) or diabetes. Pioglitazone is a drug that improves the body’s response to insulin. It is not clear whether treatment with pioglitazone could decrease the risk of cardiovascular disease or diabetes following stroke.

This study included 3876 patients who had not been previously diagnosed with diabetes. All patients had had a stroke within the previous 6 months. 1939 patients were randomly assigned to be treated with pioglitazone (group 1) and 1937 were treated with a placebo (substance with no effect on the body; group 2). Patients were contacted every 4 months for up to 5 years. 

After 5 years, 9% in group 1 and 11.8% in group 2 had another stroke or experienced a heart attack. 3.8% of group 1 patients developed diabetes compared to 7.7% in group 2.

Group 1 patients had higher rates of weight gain, edema (swelling of body tissues), shortness of breath and bone fractures.  

This study concluded that treatment with pioglitazone was associated with a lower risk of stroke, heart attack and diabetes. Pioglitazone was also associated with a number of side effects.

Pioglitazone has other activities in the body including regulating blood pressure, sugar circulation and cholesterol. This study did not identify whether the decrease in vascular disease was because of improved response to insulin, or another factor caused by the drug.

Speak to your doctor about insulin sensitivity treatment post stroke.