This session provides a mechanism-based reappraisal of pioglitazone in type 2 diabetes. As a PPAR-γ agonist, it targets insulin resistance by restoring adipose tissue function, enhancing peripheral glucose utilization, reducing hepatic glucose output, and attenuating lipotoxic-inflammatory signaling. Lectures will examine durable glycemic control, metabolic remodeling, hepatic and vascular protection, macrovascular outcomes, and integration with contemporary therapies. Evidence-based patient selection and safety reassessment will reposition pioglitazone as a clinically relevant, mechanistically grounded option in modern diabetes care.