{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:50:06Z","timestamp":1791442206754,"version":"4.3.3"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Introduction:<\/jats:title>\n Weight gain and fluid retention with pioglitazone appear dose-dependent, and South\/East Asian populations may retain glycemic benefit at lower doses. This systematic review and meta-analysis compared low-dose pioglitazone (LDP, 7.5 mg\/day) with standard-dose pioglitazone (15 mg\/day) \u2013 and secondarily with 30 mg\/day and placebo \u2013 in type-2 diabetes (T2D) and metabolic syndrome (MetS).<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n PubMed, Embase, and Cochrane Library were searched for studies of T2D and\/or MetS patients receiving pioglitazone 7.5 mg\/day versus 15\/30 mg\/day or placebo. Primary outcomes were change in body weight and body mass index (BMI); secondary outcomes were edema, glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), lipids, and liver enzymes. Random-effects (inverse-variance) models were used; heterogeneity was assessed with\n I<\/jats:italic>\n 2<\/jats:sup>\n and prediction intervals (PI). Risk of bias was assessed using RoB2 and ROB In Non-randomized Studies-of Interventions.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Twelve studies were included. Versus 15 mg\/day, 7.5 mg\/day produced significantly less weight gain (mean difference [MD]: \u22121.61 kg [95% confidence interval: \u22122.13, \u22121.08];\n P<\/jats:italic>\n < 0.001;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 56%; PI: \u22122.66, \u22120.55) and a smaller BMI rise (MD \u2212 0.47 kg\/m\n 2<\/jats:sup>\n [\u22120.68, \u22120.26];\n P<\/jats:italic>\n < 0.001;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 18%; PI: \u22120.78, \u22120.16), both robust on PI analysis. HbA1c was comparable at 3 months (MD 0.08% [\u22120.18, 0.34];\n P<\/jats:italic>\n = 0.53) and 6 months (MD 0.18% [\u22120.05, 0.42];\n P<\/jats:italic>\n = 0.13). Edema was lower with 7.5 mg\/day but only borderline (odds ratios 0.19 [0.04, 0.99];\n P<\/jats:italic>\n = 0.05;\n I<\/jats:italic>\n 2<\/jats:sup>\n = 71%) and non-significant on PI analysis. FPG was similar at 3 months but modestly higher with 7.5 mg\/day at 6 months (MD 7.71 mg\/dl [1.64, 13.78];\n P<\/jats:italic>\n = 0.01), a difference not retained on PI analysis. Low-density lipoprotein-cholesterol and triglycerides were comparable; high-density lipoprotein-cholesterol (HDL-C) was marginally lower with 7.5 mg\/day (MD: \u22122.11 mg\/dl [\u22122.47, \u22121.75]). Weight and BMI advantages were also seen versus 30 mg\/day, with comparable HbA1c. No formal non-inferiority margin was prespecified.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n LDP (7.5 mg\/day) offers HbA1c control comparable to 15 mg\/day with less weight and BMI gain, supporting it as a candidate minimum effective dose. A modest 6-month FPG difference, slightly lower HDL-C, and predominantly \u22646-month follow-up warrant confirmation in longer trials.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aam.aam_936_26","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:00:57Z","timestamp":1791439257000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Safety and Efficacy of Low Dose (7.5 mg) as Compared to Standard Dose (15 mg) Pioglitazone in Type 2 Diabetes and Metabolic Syndrome: A Systematic Review and Meta-analysis"],"prefix":"10.4103","author":[{"given":"Deep","family":"Dutta","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Center for Endocrinology, Diabetes, Arthritis and Rheumatism Superspeciality Healthcare, Dwarka, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Himachal Heart Institute, Mandi, Himachal Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sweekruti","family":"Jena","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Kalinga Hospital, Bhubaneshwar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameya","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Bhaktivedanta Hospital and Research Institute, Mira-Bhayandar, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meha","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Center for Endocrinology, Diabetes, Arthritis and Rheumatism Superspeciality Healthcare, Dwarka, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritin","family":"Mohindra","sequence":"additional","affiliation":[{"name":"Department of Medicine, Post-graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vineet","family":"Surana","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Manipal Hospitals, Dwarka, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saptarshi","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Indraprastha Apollo Hospitals, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,7]]},"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_936_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:00:57Z","timestamp":1791439257000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_936_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":0,"URL":"https:\/\/doi.org\/10.4103\/aam.aam_936_26","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"assertion":[{"value":"2026-07-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-24","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}