Effect of low dose pioglitazone on glycemic control and insulin resistance in Type 2 diabetes: A randomized, double blind, clinical trial

•Pioglitazone 7.5 mg/day as add-on therapy appears as efficacious as pioglitazone 15 mg/day and 30 mg/day as add-on therapy in terms of improving glycemic control (HbA1c and FPG, PPG).•Pioglitazone 7.5 mg/day as add-on therapy also had similar insulin sensitising actions in Type 2 diabetes patients as 15 mg/day and 30 mg/day of pioglitazone add-on therapy.•7.5 mg of pioglitazone also caused lesser side effects like weight gain, BMI, and increase in % body fat as compared to 30 mg/day of pioglitazone.•The low dose group also had a lesser number of pedal edema cases.•Hence it is advisable to start pioglitazone add-on therapy in Type 2 diabetes patients at 7.5 mg/day.

This study shows that pioglitazone 7.5 mg/day as an add-on therapy in Southeast Asian patients with Type 2 diabetes is safer and equally efficacious as the 15- and 30-mg doses of pioglitazone. Hence it is prudent to start pioglitazone therapy at a lower dose of 7.5 mg/day.