The "glitazones": rosiglitazone and pioglitazone.

ABSTRACT

Rosiglitazone and pioglitazone are two new additions to the therapeutic options for the treatment of type 2 diabetes mellitus. These agents differ from our current therapies in their mode of action. They have potential non-glucose lowering effects that may reduce cardiovascular risk and are effective both as monotherapy and in combination with sulfonylureas, metformin, and insulin. They are generally well tolerated, with the main side effects being weight gain and fluid retention. However, special precaution is warranted in patients with congestive heart failure or hepatic disease, and monitoring of liver enzymes is recommended for the first year of therapy. Despite their effectiveness, rosiglitazone and pioglitazone remain second-line agents to metformin and glyburide, agents that have demonstrated efficacy in decreasing the microvascular and macrovascular complications associated with type 2 diabetes mellitus.