Effect of pioglitazone on nerve conduction velocity of the median nerve in the carpal tunnel in type 2 diabetes patients

AIM To evaluate the impact of pioglitazone pharmacotherapy in median nerve electrophysiology in the carpal tunnel among type 2 diabetes patients.METHODS The study was executed in patients with type 2 diabetes, treated with oral drugs, categorized under pioglitazone or non-pioglitazone group(14 in each group), and who received electrophysiological evaluation by nerve conduction velocity at baseline and 3 mo.RESULTS At 3 mo, pioglitazone-category had inferior amplitude in sensory median nerve [8.5 interquartile range(IQR) = 6.5 to 11.5) vs non-pioglitazone 14.5(IQR 10.5 to 18.75)](P = 0.002). Non-pioglitazone category displayed amelioration in amplitude in the sensory median nerve [baseline 13(IQR = 9 to 16.25) vs 3 mo 8.5(IQR = 6.5 to 11.5)](P = 0.01) and amplitude in motor median nerve [baseline 9(IQR = 4.75 to 11) vs 3 mo 6.75(IQR = 4.75 to 10.25)](P = 0.049); and deterioration of terminal latency of in motor ulnar nerve [baseline 2.07(IQR = 1.92 to 2.25) vs 3 mo 2.16(IQR = 1.97 to 2.325)](P = 0.043). There was amelioration of terminal latency in sensory ulnar nerve [baseline 2.45(IQR = 2.315 to 2.88) vs 3 mo 2.37(IQR = 2.275 to 2.445) for pioglitazone group(P = 0.038).CONCLUSION Treatment with pioglitazone accentuates probability of compressive neuropathy. In spite of comparable glycemic control over 3 mo, patients treated with pioglitazone showed superior electrophysiological parameters for the ulnar nerve. Pioglitazone has favourable outcome in nerve electrophysiology which was repealed when the nerve was subjected to compressive neuropathy.