Effect of thiazolidinediones on body weight in patients with diabetes mellitus
Abstract
Treatment of diabetes mellitus with medications, including insulin, sulfonylureas, and thiazolidinediones (TZDs), often leads to weight gain through a variety of mechanisms. Weight gain can have adverse consequences for patients with type 2 diabetes, many of whom are overweight or obese, because obesity is linked to insulin resistance and other medical consequences such as cardiovascular disease. TZDs improve glycemic control and insulin sensitivity in patients with type 2 diabetes, despite their potential to cause weight gain. Studies have attempted to elucidate the mechanisms behind the apparent paradox of TZDs improving insulin sensitivity while causing weight gain. Data indicate that with TZD treatment, there is a favorable shift in fat distribution from visceral to subcutaneous adipose depots that is associated with improvements in hepatic and peripheral tissue sensitivity to insulin. Although weight gain may occur with TZD therapy, it is not inevitable. A weight-management program combining a low-calorie, low-sodium diet with education and behavior modification has been shown to be effective in patients with type 2 diabetes being treated with TZDs. Further research is needed to define the optimal dietary modifications that can be used universally in TZD-treated patients to minimize weight gain while effectively treating insulin resistance and hyperglycemia.
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The majority of antidiabetic agents, including insulin, thiazolidinediones, and insulin secretagogues, lead to body weight gain while controlling glycemia.
“However, the majority of antidiabetic agents, including insulin, thiazolidinediones, (TZDs) and insulin secretagogues, lead to body weight gain while controlling glycemia (47–49).”
From GDF-15 as a Weight Watcher for Diabetic and Non-Diabetic People Treated With Metformin (2020) · cites this paper as [48]
Thiazolidinediones (pioglitazone and rosiglitazone) are PPAR-γ agonists that may cause weight gain with a favorable shift in fat distribution from VAT to SAT in T2DM patients.
“Thiazolidinediones (pioglitazone and rosiglitazone) are PPAR-γ agonists that, administered to T2DM patients, may cause weight gain with a favorable shift in fat distribution from VAT to SAT [164].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [164]
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- Authors
- Fonseca, V.
- Affiliations
- Tulane University (US)
- Corresponding author
- Fonseca, Vivian
- ORCID
- Fonseca, Vivian
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2003-12
- Volume
- 115
- Issue
- 8
- Pages
- 42-48
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2080424087
- Cited by
- 283
- References
- 57
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 13 · 2021: 12 · 2020: 12 · 2019: 14 · 2018: 11 · 2017: 11 · 2016: 20 · 2015: 15 · 2014: 13 · 2013: 12 · 2012: 10
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- The American Journal of Medicine
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- thiazolidinediones, weight gain, type 2 diabetes, insulin resistance, visceral adipose tissue, subcutaneous adipose tissue, body fat distribution, hepatic insulin sensitivity, weight management, hypocaloric diet, behavior modification, hyperglycemia
- MeSH terms
- Adipose Tissue, Body Weight, Cardiovascular Diseases, Diabetes Mellitus, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Insulin Resistance, Obesity, Weight Gain, Comorbidity, Thiazolidinediones
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