Approximately 75% of patients with diabetes die from cardiovascular disease. Determining the optimal treatment for diabetes patients with coronary artery disease is the subject of a recent JAMA article.

Steven E. Nissen, MD, Cleveland Clinic, and colleagues, compared the effectiveness of two alternative approaches for treating hyperglycemia, an insulin-providing strategy (glimepiride) versus an insulin-sensitizing strategy (pioglitazone), in reducing progression of atherosclerosis in 543 patients with type 2 diabetes and coronary disease.

Pioglitazone was found to be more effective at lowering the rate of progression of plaque build-up in coronary arteries than that of glimepiride. Patients taking pioglitazone exhibited a lower rate of progression of coronary atherosclerosis.

Researchers feel their findings may have an important implication for defining the optimal strategy for management of patients with type 2 diabetes and coronary atherosclerosis.