title: The current role of thiazolidinediones in diabetes management.
abstract: Among the epidemics of modern time, type 2 diabetes mellitus (T2DM) is one of the main contributors to overall morbidity as well as mortality. A number of different treatment options are available for the management of diabetes. Among them thiazolidinediones (TZDs) is an interesting drug class since it does not target the result of T2DM, i.e., hyperglycemia but rather some of the core mechanisms of the disease. Indeed, glitazones increase insulin sensitivity by activating the peroxisome proliferator-activated receptor γ, which plays an important role in regulating various metabolic parameters. Although TZDs have an established efficacy in T2DM treatment, their usage during the past years was questioned following the emergence of some alarming data regarding their safety and especially the cardiovascular safety of rosiglitazone. As a result, there is often some skepticism about the current role of TZDs in T2DM management. This mainly affects rosiglitazone even leading to its withdrawal from several markets in contrast to pioglitazone, which has shown a beneficial cardiovascular profile. A comprehensive assessment of the benefit-to-risk ratio of TZDs is required in order to better understand the place of these drugs in T2DM management.
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece.
authors.forename: Christos V
authors.initials: CV
authors.lastname: Rizos
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece.
authors.forename: Anastazia
authors.initials: A
authors.lastname: Kei
authors.affiliation: Department of Internal Medicine, Medical School, University of Ioannina, 45110, Ioannina, Greece. egepi@cc.uoi.gr.
authors.forename: Moses S
authors.initials: MS
authors.lastname: Elisaf
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000139:chemically induced; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D050723:Fractures, Bone / Q000139:chemically induced; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D007333:Insulin Resistance; D008099:Liver / Q000187:drug effects / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D001749:Urinary Bladder Neoplasms / Q000139:chemically induced
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones
keywords: Cardiovascular effects; Diabetes mellitus; Efficacy; Pioglitazone; Pleiotropic effects; Rosiglitazone; Safety; Thiazolidinediones