Pioglitazone (Pio), a thiazolidinedione (TZD) with vascular protection and the ability to ameliorate atherosclerosis progression due to its potent effect as a peroxisome proliferator-activated receptor-γ (PPAR-γ) agonist, may reduce recurrent stroke in patients with T2DM or insulin resistance (11, 12). This evidence concerns the gene PPARG and type 2 diabetes mellitus.