Last updated August 21, 2026
Key finding
The duration of HbA1c being maintained at <7.9% was longer in the SU group than the other groups.
This study evaluated the effects of pioglitazone and sulfonylurea on diabetes remission and atherosclerosis in Japan, finding significant differences in HbA1c levels among treatment groups.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Long-Term (1–5 y)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the effects of pioglitazone and sulfonylurea on diabetes remission and atherosclerosis in Japan, finding significant differences in HbA1c levels among treatment groups.
These findings highlight the importance of medication choices in managing type 2 diabetes. Understanding the differential impacts of pioglitazone and sulfonylurea can guide clinicians in optimizing treatment strategies for better patient outcomes.
The study may have limited generalizability due to its specific population. Potential confounding factors were not fully controlled. The duration of follow-up may not capture long-term effects.
Published in
Publication details and source links for this paper.
Hidenori H, Mitsuru H, Yukio T, Kohei K. Pioglitazone and Sulfonylurea Remission from Type 2 Diabetes Mellitus Development and Anti-Atherosclerosis in Japan. Journal of Diabetes Investigation. 2018;9(5):1119-1127. doi:10.1111/jdi.12813
Sulfonylurea group maintained HbA1c <7.9% for 1.5 months longer (p=0.01).
Sulfonylurea group had a significantly shorter duration of HbA1c <7.4% by -1.2 months (p=0.05).
30% of patients in the SU and PIO groups achieved HbA1c <6.9% (p=0.001).
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Lifestyle intervention for prediabetes, Pioglitazone and Duration of HbA1c maintained at <7.9%, Adiponectin, C-reactive protein, and 3 more.
This study contributes evidence to
Primary intervention
Lifestyle intervention for prediabetes
Primary outcomes
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
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Related topics
6
Evidence pairs
960
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Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Related evidence
Evidence relationship
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Evidence relationship
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Core evidence
The primary outcomes reported in this study.
Lifestyle intervention for prediabetes → Duration of HbA1c maintained at <7.9%
Lifestyle intervention for prediabetes → Duration of HbA1c maintained at <7.9%
Pioglitazone → Duration of HbA1c maintained at less than 7.4%
Pioglitazone → Duration of HbA1c maintained at less than 7.4%
Pioglitazone → Proportion achieving HbA1c <7.0%
Pioglitazone → Proportion achieving HbA1c <7.0%
Evidence Library
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Thiazolidinediones and Adipokine and Angiogenic Markers, Thiazolidinediones and HbA1c.
This study contributes to the evidence on the following intervention-outcome relationships.
Medications
Curated evidence collections and hubs this study is part of.
All studies measuring Adipokine and Angiogenic Markers
Measures Adipokine and Angiogenic Markers as a key outcome.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies on Thiazolidinediones
Contributes to Thiazolidinediones evidence base.
Jump to pre-filtered views in Evidence Explorer.
2 results
2 results
2 results
2 results
2 results
Generated from the study's connected evidence using Evidence Intelligence™.
Thiazolidinediones appears to improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Proportion achieving HbA1c <7.0%
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 6 supporting studies with consistent results and a positive effect signal.
Limitations
Thiazolidinediones may improve Adipokine and Angiogenic Markers.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Adiponectin
EvidenceScore™ Moderate | EvidenceScore™ 69.0 | strong positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on 3 supporting studies with consistent results and a positive effect signal.
Limitations
Current evidence does not show a clear benefit of Thiazolidinediones for Insulin Resistance.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Insulin resistance
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Thiazolidinediones for Inflammatory Markers.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
C-reactive protein
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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