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OBJECTIVE—To elucidate the effects of pioglitazone treatment on glucose and lipid metabolism in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS—A total of 23 diabetic patients (age 30–70 years, BMI < 36 kg/m²) who were being treated with a stable dose of sulfonylurea were randomly assigned to receive either placebo (n = 11) or pioglitazone (45 mg/day) (n = 12) for 16 weeks. Before and after 16 weeks of treatment, all subjects received a 75-g oral glucose tolerance test (OGTT); and hepatic and peripheral insulin sensitivity was measured with a two-step euglycemic insulin (40 and 160 mU · min⁻¹ · m^–2) clamp performed with 3-[³H]glucose and indirect calorimetry. HbA_1c was measured monthly throughout the study period.

RESULTS—After 16 weeks of pioglitazone treatment, the fasting plasma glucose (FPG; 184 ± 15 to 135 ± 11 mg/dl, P < 0.01), mean plasma …