- Type 2 Diabetes: Learn the Warning Signs
- Diabetes Friendly Dining
- Type 2 Diabetes: Test Your Medical IQ
- What is Actos (pioglitazone)?
- Is Actos (pioglitazone) available as a generic drug?
- Do I need a prescription for Actos (pioglitazone)?
- Why is Actos (pioglitazone) prescribed to patients?
- What are the side effects of Actos (pioglitazone)?
- What is the dosage for Actos (pioglitazone)?
- Which drugs or supplements interact with Actos (pioglitazone)?
- Is Actos (pioglitazone) safe to use during pregnancy or while breastfeeding?
- What else should I know about Actos (pioglitazone)?
What is Actos (pioglitazone)?
- Pioglitazone is an oral drug that reduces the amount of glucose (sugar) in the blood. It is in a class of anti-diabetic drugs called thiazolidinediones that are used in the treatment of type 2 diabetes. The other member in this class is rosiglitazone (Avandia). (Another member of this class, troglitazone or Rezulin, was removed from the market because of liver toxicity.)
Quick GuideDiabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating
Why is Actos (pioglitazone) prescribed to patients?
- Actos is used for the treatment of type 2 diabetes in adults. It is used along with a healthy diabetic diet, regular exercise, weight control, smoking reduction, and careful monitoring of blood glucose.
- Actos may be used alone or in combination with metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet), a drug in a different class of anti-diabetic drugs, that also lowers blood glucose.
- Actos requires naturally-secreted insulin to be effective so it is not recommended in type 1 diabetes where the amount of insulin is very low or absent.
- Nevertheless, Actos is approved for treating type 2 diabetes in combination with insulin as well as another class of diabetes drugs, the sulfonylureas, that increases the amount of insulin produced.
What are the side effects of Actos (pioglitazone)?
ACTOS BLACK BOX WARNING
- Actos and similar drugs can cause or women congestive heart failure in some patients.
- Patients should be monitored for signs and symptoms of heart failure (for example, excessive, rapid weight gain, dyspnea, and/or edema) at the beginning of treatment and after dose increases.
- Actos is not recommended for patients with symptomatic heart failure and patients with established New York Heart Association (NYHA) Class III or IV heart failure should not use Actos.
Other side effects of Actos
The most common side effects of Actos alone or in combination with sulfonylureas, metformin, or insulin are:
- Upper respiratory tract infection
- Muscle aches
- Tooth disorders
- Hypoglycemia (low blood sugar)
- Sore throat
Possible serious side effects of Actos include:
Dose related fluid accumulation (edema) can occur especially when combined with insulin. Fluid accumulation can worsen or lead to heart failure. Actos should not be used in patients with heart disease classified by the New York Heart Association (NYHA) as Class III and IV heart failure or symptomatic heart failure.
Fluid accumulation also may lead to macular edema, resulting in reduced vision. Actos also can reduce red blood cells.
There have been post-marketing reports of liver failure while taking Actos.
Actos has been associated with liver injury. Periodic monitoring of liver-related side effects and liver tests should be conducted in patients taking Actos.
Symptoms of liver injury are:
Actos should be stopped if patients have symptoms of liver injury and liver function test results that are greater than three times the normal level. Liver blood tests are obtained before starting treatment. Monitoring liver tests during treatment is not recommended for patients without liver disease.
Actos may cause ovulation in women who have stopped ovulating if they are premenopausal and insulin resistant. This may lead to pregnancy. For women (but not men) taking Actos, there is an increased risk of bone fractures of the distal bones of the arm and leg. Patients taking Actos should maintain proper bone health.
What is the dosage for Actos (pioglitazone)?
- Actos is prescribed once daily in doses ranging from 15 to 45 mg.
- The recommended starting dose for patients without heart failure is 15 or 30 mg and for those with heart failure it is 15 mg daily. The dose may be increased in 15 mg intervals to a maximum dose of 45 mg daily if needed.
- Actos may be taken any time of the day, with or without meals.
- If a dose is missed on one day, two doses should not be taken the next day to make up for the missed dose.
Quick GuideDiabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating
Which drugs or supplements interact with Actos (pioglitazone)?
- Gemfibrozil reduces the break down of Actos by certain liver enzymes, increasing blood levels and possibly side effects of Actos. The maximum dose of Actos should not exceed 15 mg daily when combined with gemfibrozil or other drugs that reduce the activity of liver enzymes that break down Actos. Conversely, rifampin increases the breakdown of Actos by the liver, reducing blood levels and possibly the effects of Actos.
Is Actos (pioglitazone) safe to use during pregnancy or while breastfeeding?
- There are no adequate studies of Actos in pregnant women. Actos may be used in pregnancy if the physician feels the potential risks are justified.
- It is unknown if Actos is secreted in breast milk. Therefore, the effect of Actos on the nursing infant whose mother is taking Actos is unknown.
What else should I know about Actos (pioglitazone)?
What preparations of Actos (pioglitazone) are available?
- Tablets: 15, 30 and 45 mg.
How should I keep Actos (pioglitazone) stored?
- Tablets should be kept at room temperature, 15 C -30 C (59 F -86 F).
How does Actos (pioglitazone) work?
- Patients with type 2 diabetes cannot make enough insulin, and the cells of their body respond less to the insulin that is produced. Since insulin is the hormone that stimulates cells to remove glucose from the blood, the reduced amount of insulin and its reduced effect cause cells to take up less glucose from the blood and the level of glucose in the blood to rise. Pioglitazone often is referred to as an "insulin sensitizer" because it attaches to the insulin receptors on cells throughout the body and causes the cells to become more sensitive (more responsive) to insulin. As a result, more glucose is removed from the blood, and the level of glucose in the blood falls. At least some insulin must be produced by the pancreas in order for pioglitazone to work. Pioglitazone also lowers the level of glucose in the blood by reducing the production and secretion of glucose into the blood by the liver. In addition, pioglitazone may alter the blood concentrations of lipids (fats) in the blood. Specifically, it decreases triglycerides and increases the "good" (HDL) cholesterol.
When was Actos (pioglitazone) approved by the FDA?
- Pioglitazone received FDA approval in July 1999.
REFERENCE: FDA Prescribing Information
Quick GuideDiabetes Diet: Healthy Meal Plans for Diabetes-Friendly Eating
Actos (pioglitazone) is a drug prescribed for the treatment of type 2 diabetes. Side effects include:
- Sore throat
- Low blood sugar (hypoglycemia)
- Tooth disorders
- Upper respiratory tract infection
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Diabetes and Kidney DiseaseIn the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose increase the risk that a person with diabetes will eventually progress to kidney failure. Kidney disease in people with diabetes develops over the course of many years. albumin and eGFR are two key markers for kidney disease in people with diabetes. Controlling high blood pressure, blood pressure medications, a moderate protein diet, and compliant management of blood glucose can slow the progression of kidney disease. For those patients who's kidneys eventually fail, dialysis or kidney transplantation is the only option.
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Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
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Diabetes TreatmentThe major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with:
- and a diabetic diet.
- weight reduction,
- a diabetic diet,
- and exercise.
Diabetic Diet for Type 2 DiabetesA type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as:
- the Mediterranean diet,
- Paleo diet,
- ADA Diabetes Diet,
- and vegetarian diets.
Fatty LiverNonalcoholic fatty liver disease occurs due to the accumulation of abnormal amounts of fat within the liver. Fatty liver most likely caused by obesity and diabetes. Symptoms of fatty liver disease are primarily the complications of cirrhosis of the liver; and may include:
- mental changes,
- liver cancer,
- the accumulation of fluid in the body (ascites, edema), and
- gastrointestinal bleeding.
- weight loss, and
- bariatric surgery.
Foot Problems (Diabetes)Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
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- steroid use.
Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
Metabolic SyndromeThe main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese. Lifestyle modification such as the Mediterranean diet, exercise, and quitting smoking are the preferred treatment of metabolic syndrome.
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Type 1 vs Type 2 Diabetes Similarities Differences
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million children and adults in the US have diabetes. Of that, 8.1 million people have diabetes and don't even know it. Type 1 diabetes (insulin-dependent, juvenile) is caused by a problem with insulin production by the pancreas. Type 2 diabetes (non-insulin dependent) is caused by:
Eating a lot of foods and drinking beverages with simple carbohydrates (pizza, white breads, pastas, cereals, pastries, etc.) and simple sugars (donuts, candy, etc.)
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- Lack of activity
While the signs and symptoms of both types of diabetes are the same, which include:
- Increased urination
- Increased hunger
- Increased thirst
- Unexplained weight loss.
However, the treatments are different. Type 1 diabetes is insulin dependent, which means a person with this type of diabetes requires treatment with insulin. People with type 2 diabetes require medication, lifestyle changes like eating a healthy diet, and getting regular exercise.
Type 2 Diabetes
Type 2 diabetes is a condition in which a person's pancreas does not produce enough insulin to meet the needs of the body. Causes of type 2 diabetes are a sedentary lifestyle, eating excess sugar and carbohydrates, lack of exercise, being overweight, and genetics. Symptoms of type 2 diabetes are often subtle, but may include:
- Urine odor
- Unintentional weight gain or loss
- Frequent urination
- Dark skin under the chin, armpits, or groin
Type 2 diabetes is diagnosed by a blood test. Treatment for type 2 diabetes are a healthy type 2 diabetes diet, exercise, stress reduction, and medication. Type 2 diabetes is a preventable disease. Incorporating healthy lifestyle changes (for example, eating a healthy diet, exercising more, and reducing stress) can prevent type 2 diabetes.
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