Antihyperglycemics (thiazolidinediones / TZDs)
- Insulin sensitizers: pio/rosiglitazone
- Durable A1c lowering; low hypo alone
- Pioglitazone may help steatotic liver disease
- Weight gain + edema are common
- Can precipitate/worsen heart failure
- Fracture risk increases
- Slow onset; inexpensive
Class at a glance
- Insulin sensitizers: pio/rosiglitazone
Members / distinctions
- Durable A1c lowering; low hypo alone
- Pioglitazone may help steatotic liver disease
Practical pearls
- Can precipitate/worsen heart failure
- Slow onset; inexpensive
Safety / monitoring
- Weight gain + edema are common
- Fracture risk increases
Pearls
- Contraindicated in NYHA class III–IV heart failure
- Also bladder cancer and macular edema concerns
- Rosiglitazone not marketed in US; pioglitazone is the option
Self-check
- What common adverse effects occur with TZDs?
Weight gain and edema. - What major cardiac problem can TZDs worsen?
Heart failure.
Drugs in this class (2)
Antihyperglycemics (thiazolidinediones / TZDs) prescription history
Animated chart of estimated U.S. prescriptions per year, Diabetes meds (1923–2026). TZD highlighted from 1997.
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