Association of pioglitazone treatment with decreased bone mineral density
In this Danish trial in just 16 weeks, pioglitazone associated with 1 to 1.4% loss of bone density compared to placebo. http://jcem.endojournals.org/cgi/content/abstract/jc.2007-2249v1
Is this surprising considering that this group of drugs has never been shown to have the safe anabolic benefits of metformin?- which reduces fat mass and increases lean mass, and growth in teenagers with polycystic ovary syndrome.
Metformin reduces lipidemia, new diabetes by half and in diabetics almost halves mortality and all major chronic degenerative diseases. By contrast, like sulphonylureas, gliptins, appetite suppressants and other wannabe metformin substitutes the glitazones and statins have never been shown to have global benefit long term on all-cause mortality and all common aging degenerative diseases – let alone the incredible safety of metformin when used sensibly. Nor has insulin when added as last-ditch therapy in resistant type 2 diabetes.
So it is increasingly medical negligence to prescribe anything but metformin to tolerance early on and permanently in the overweight, including in common maturity-onset diabetics and those with common lipidemia and hypertension, if lifestyle, diet and a blend of natural supplements (including appropriate parenteral sex hormone replacement in men and women with such imbalance) that reduce insulin resistance are inadequate.
There are no long term contraindications to metformin adjusted to tolerance with sensible monitoring.