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 Pioglitazone has favourable outcome in nerve electrophysiology which was repealed when the nerve was subjected to compressive neuropathy. AIM To evaluate the impact of pioglitazone pharmacotherapy in the 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 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 = 0.002) 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 [ 2.07 (IQR = 1.92 to 2.25) vs 3 mo 2.16 (IQR = 1.97 to 2. 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) 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 .