Actos, the Latest of the Diabetes Fighters

Actos, released this summer by Lilly and Co. in collaboration with Takeada Pharmaceuticals, is the latest of the oral agents for treatment of diabetes. Actos whose chemical name is pioglitazone, is part of the new class of diabetes fighting drugs called “glitazones”. Other drugs in this class are Rezulin(Parke Davis/Sankyo) and Avandia (Bristol Myers Squibb). Glitazones work by making the body more sensitive to insulin. This is important because diabetes develops in up to 92% of Type 2 Diabetics (adult onset variety) due to an impairment of the body’s ability to utilize the insulin already in the blood. This defect is called insulin resistance and is a genetically determined (inherited) characteristic. Certain drugs such as steroids (Prednisone, cortisone) can make insulin resistance worse as can obesity.

Use alone or in combination

Actos can be used alone or in combination with a variety of other diabetes treatments. Many diabetics are already taking pills of a type known as sulfonylureas, including Glucotrol, Amaryl, Prandin, Micronase and Diabeta. Glitazones such as Actos can be combined with these to create an enhancement of the blood sugar lowering effect. What’s more Actos can be combined with the other classes of anti-diabetes drugs including Glucophage (metformin) and even insulin itself. Some Type 2 diabetics who are taking insulin can have their insulin doses reduced or even eliminated after starting Actos.

Generally safe to use

The first glitazone released over 2 years ago, Rezulin, received a lot of negative attention due to its association with a rare but potentially lethal side effect of liver failure. Fortunately there is no indication so far that the two newest glitazones, Actos and Avandia, produce this complication. Both new glitazones can cause fluid retention and should be used with great caution in individuals with heart failure.

Can improve cholesterol levels

An additional benefit to Actos is its ability to improve the abnormal cholesterol (lipid) profile usually seen with Type 2 diabetes. High triglyceride levels with low HDL (good cholesterol) and high LDL (bad cholesterol) is a common combination of lipid abnormalities in diabetics. Actos has been shown to lower triglyceride levels by about 10%, raise HDL by about 20% and have a neutral effect on LDL. Only Rezulin has shown similar beneficial effects among the glitazones.

Actos is a great addition to the available drugs for treatment of diabetes. As always, consult with your health care provider before embarking on any changes in your treatment regime.

We gratefully acknowledge that this page is supported in part by a grant from the Eli Lilly company

For more information about Actos, visit the Actos web site at

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