ACTOS NOW FOR PREVENTION OF DIABETES (ACT NOW)

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。目的：研究吡格列酮与安慰剂相比是否能降低糖耐量受损（IGT）向2型糖尿病的转化率。 研究方法：IGT受试者将通过口服葡萄糖耐量试验（OGTT）进行鉴定。合格受试者还将使用频繁采样的静脉内葡萄糖耐量试验（FSIVGTT）测量第一时相胰岛素分泌和胰岛素敏感性，并使用颈动脉超声测量颈动脉内膜中层厚度。在这些测量之后，受试者将随机接受吡格列酮或安慰剂，他们将每3个月返回一次，以测定空腹血糖（FPG）浓度和中期病史。招聘将在15个月内进行。从招募期结束时起，将对接受吡格列酮或安慰剂治疗的受试者进行总计24个月的随访。将在15、27和39个月时重复OGTT，或者如果3个月随访访视时FPG ≥ 126 mg/dl，则重复OGTT。如果在39个月前或39个月时确诊糖尿病，将重复FSIVGTT和颈动脉超声检查。在39个月时，受试者将从吡格列酮或安慰剂中洗脱，并在45个月时重复OGTT、FSIVGTT和颈动脉超声。 临床相关性：IGT是一种前驱糖尿病状态。如果IGT可以预防发展为显性糖尿病，那么这种毁灭性疾病的高血糖相关并发症就可以预防。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVE: To examine whether pioglitazone versus placebo can reduce the conversion rate of impaired glucose tolerance (IGT) to type 2 diabetes mellitus. RESEARCH PLAN AND METHODS: Subjects with IGT will be identified with an oral glucose tolerance test (OGTT). Eligible subjects also will have a measurement of first phase insulin secretion and insulin sensitivity using the frequently sampled intravenous glucose tolerance test (FSIVGTT) and carotid intimal media thickness using carotid ultrasound. Following these measurements subjects will be randomized to receive pioglitazone or placebo and they will return every 3 months for determination of fasting plasma glucose (FPG) concentration and interim medical history. Recruitment will take place over 15 months. From the time that the recruitment period ends, subjects will be followed for a total of 24 months on pioglitazone or placebo. The OGTT will be repeated at 15, 27, and 39 months, or if the FPG is = 126 mg/dl on the 3-month follow up visits. If the diagnosis of diabetes is established before month 39 or at month 39, the FSIVGTT and carotid ultrasound will be repeated. At 39 months, subjects will be washed out of pioglitazone or placebo and the OGTT, FSIVGTT, and carotid ultrasound will be repeated at month 45. CLINICAL RELEVANCE: IGT is a prediabetic state. If IGT can be prevented from progressing to overt diabetes, the hyperglycemia-related complications of this devastating disease can be prevented.