Cited by 388Diabetes Treatment and ManagementPeroxisome Proliferator-Activated ReceptorsDiabetes, Cardiovascular Risks, and Lipoproteins

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Thiazolidinediones: the Forgotten Diabetes Medications

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Lebovitz, Harold E.·2019·Current Diabetes Reports

DOI 10.1007/s11892-019-1270-yPMC PMC6881429

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Abstract

Purpose of Review: Thiazolidinediones (TZDs) are the only pharmacologic agents that specifically treat insulin resistance. The beneficial effects of TZDs on the cardiovascular risk factors associated with insulin resistance have been well documented. TZD use has been limited because of concern about safety issues and side effects. Recent Findings: Recent studies indicate that cardiovascular toxicity with rosiglitazone and increase in bladder cancer with pioglitazone are no longer significant issues. There are new data which show that pioglitazone treatment reduces myocardial infarctions and ischemic strokes. New data concerning TZD-mediated edema, congestive heart failure, and bone fractures improves the clinician’s ability to select patients that will have minimal significant side effects. Summary: Thiazolidinediones are now generic and less costly than pharmaceutical company–promoted therapies. Better understanding of the side effects coupled with clear benefits on the components of the insulin resistance syndrome should promote TZD use in treating patients with type 2 diabetes.

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Fig. 1 Insulin-resistant type 2 diabetes is the co-existence of two separate metabolic abnormalities: a primary beta-cell disease: diabetes mellitus and a lipid distribution abnormality which creates insulin resistance, the metabolic syndrome, and increased cardiovascular disease. These abnormalities can be separate or co-exist. These abnormalities can interact in susceptible populations leading to an increase in the prevalence of diabetes and an increase in atherosclerotic diseaseCC BY · PubMed Central

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Authors: Lebovitz, H. E.
Affiliations: SUNY Downstate Health Sciences University (US)
Corresponding author: Lebovitz, Harold E.
Venue: Current Diabetes Reports
Publisher: Springer Science and Business Media LLC
Published: 2019-11-27
Volume: 19
Issue: 12
Pages: 151-151
ISSN: 1534-4827 (ISSN-L)
1539-0829
DOI: 10.1007/s11892-019-1270-y
PMC: PMC6881429
OpenAlex: W2990309084
Cited by: 388
References: 85
Citations by year: 2026: 45 · 2025: 62 · 2024: 75 · 2023: 68 · 2022: 65 · 2021: 57 · 2020: 16
FWCI: 5.29
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: Current Diabetes Reports (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Peroxisome Proliferator-Activated Receptors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: thiazolidinediones, insulin resistance, type 2 diabetes, rosiglitazone, pioglitazone, cardiovascular risk, myocardial infarction, ischemic stroke, bladder cancer, congestive heart failure, edema, bone fractures, drug safety, generic drugs
MeSH terms: Rosiglitazone, Pioglitazone, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Insulin Resistance, Thiazolidinediones

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