In insulin combination studies, small number of patients with history of previously existing cardiac disease developed congestive heart failure when treated with ACTOS in combination with insulin see WARNINGS. Know the signs of low blood sugar hypoglycemia and how to recognize them: hunger, headache, confusion, drowsiness, weakness, dizziness, sweating, fast seizure convulsions or fainting, coma severe hypoglycemia can be fatal. The primary efficacy variable was the time to the first occurrence of any event in the cardiovascular composite endpoint see table below. Across all clinical studies, mean hemoglobin values declined by to in patients treated with ACTOS. These elevations resolved without any apparent clinical sequelae. 001 but pioglitazone-related diastolic improvement was not associated with changes in myocardial substrate metabolism. If pioglitazone aus indien any of these effects persist or worsen, notify your doctor or pharmacist promptly.