 Background: Despite drug-eluting stents DES, diabetic patients remain at high risk of restenosis and poor clinical outcomes after percutaneous coronary intervention PCI. Studies have suggested poor glycemic control and insulin resistance may be predictors of poor outcomes after PCI. There are conflicting studies as to whether strategies to improve glycemic control can improve outcomes after PCI. Thiazolidinediones, such as pioglitazone PIO, may have anti-restenotic benefits, independent of glycemic control. 