Troglitazone: current therapeutic role in type 2 diabetes mellitus.
OBJECTIVE
To describe the role of troglitazone in the treatment of non-insulin-dependent diabetes mellitus.


METHODS
The potential mechanisms of action of the thiazolidinediones are outlined, and studies that have been conducted in animals and in humans are reviewed.


RESULTS
Although the precise mode of action of troglitazone, a thiazolidinedione, is unknown, this agent is an insulin sensitizer that has been shown to decrease fasting insulin, fasting plasma glucose, and blood pressure levels in humans. The effect of troglitazone is progressively greater over time; in several studies, the maximal action occurred as long as 12 weeks after initiation of treatment. The usual daily dose is 200 to 600 mg, and no dosage adjustment is necessary in patients with renal insufficiency. Adverse events, including fluid retention and hepatic dysfunction, may limit the utility of troglitazone in some clinical situations.


CONCLUSIONS
Both in monotherapy and in combination with sulfonylureas, insulin, or metformin, troglitazone has proved to be an effective agent for the treatment of type 2 diabetes mellitus.
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