Combined Intervention With Pioglitazone and n-3 Fatty Acids in Metformin-treated Type 2 Diabetic Patients

Data represent a median and interquartile range (Q1, Q3). Various parameters were analyzed in overnight (8–10-h) fasting patients at baseline and at week 24 of the respective interventions. Δ, a difference between week 24 and baseline values; Δ (%), a difference between week 24 and baseline values in % of the baseline value; BW, body weight; BMI, body mass index, NEFA, non-esterified fatty acids; SOD, superoxide dismutase; TBARS, thiobarbituric acid reactive substances; GSSH, oxidized glutathione; GSH, reduced glutathione. ^{a, b, c}Significant differences compared with Placebo, Pio, and Omega-3, respectively

Data represent a median and interquartile range (Q1, Q3). Glycemia and plasma HbA_1c levels were measured in overnight (8–10-h) fasting patients, while glucose disposal rate (M) was evaluated using hyperinsulinemic-euglycemic clamp at baseline and at week 24. Δ, a difference between week 24 and baseline values, Δ (%), a difference between week 24 and baseline values in % of the baseline value. ^{a, b, c}Significant differences compared with Placebo, Pio, and Omega-3, respectively

Data represent a median and interquartile range (Q1, Q3). Data were obtained using indirect calorimetry performed in conjunction with hyperinsulinemic-euglycemic clamp at week 24 (see Table 2). Differences between parameters measured during the clamp and fasting state are also shown (Diff C-F). REE, resting energy expenditure; RQ, respiratory quotient; GDR, glucose disposal rate (indirect calorimetry). For evaluation of the effect of respective interventions on RQ (metabolic flexibility), see also Fig. 3. Non-oxidative glucose GDR was calculated as described in Methods. No significant differences between subgroups were found

Authors and Disclosures

Jiri Veleba¹, Jan Kopecky Jr.¹, Petra Janovska², Ondrej Kuda², Olga Horakova², Hana Malinska¹, Ludmila Kazdova¹, Olena Oliyarnyk¹, Vojtech Skop¹, Jaroslava Trnovska¹, Milan Hajek¹, Antonin Skoch¹, Pavel Flachs², Kristina Bardova², Martin Rossmeisl², Josune Olza³, Gabriela Salim de Castro³, Philip C. Calder³, Alzbeta Gardlo^2,4, Eva Fiserova⁴, Jørgen Jensen⁵, Morten Bryhn⁶, Jan Kopecky Sr.²* and Terezie Pelikanova¹*

¹Institute for Clinical and Experimental Medicine, Prague, Czech Republic. ²Department of Adipose Tissue Biology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic. ³Human Development & Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK. ⁴Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacky University, Olomouc, Czech Republic. ⁵Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway. 6Silentia AS, Svelvik, Norway.

*Correspondence
kopecky@biomed.cas.cz; tepe@medicon.cz

Competing interests
The authors declare that they have no competing interests associated with this study.

Authors' contributions
MB, PCC, JK Sr., TP designed the study and wrote the manuscript. JV, JK Jr. and TP recruited the patients and acquired the clinical data. PJ, OK, OH, HM, LK, OO, VS, JT, MH, AS, PF, KB, MR, JO, GSC, and JJ were involved in the acquisition and analysis of the laboratory data. AG and EF carried out the statistical analyses and interpretation of the data. All authors had full access to data and approved the manuscript for publication. JK Sr. and TP wrote the grant application and are the guarantors.