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Thiazolidinediones in the treatment of diabetes mellitus

David K McCulloch, MD
Section Editor
David M Nathan, MD
Deputy Editor
Jean E Mulder, MD


Two classes of oral hypoglycemic drugs improve insulin action as their primary effect: biguanides and thiazolidinediones. Two thiazolidinediones (rosiglitazone and pioglitazone) are currently available in the United States. In 2010, the European Medicines Agency suspended sales of rosiglitazone, and in June 2011, the French and German Medicines Agencies also suspended the use of pioglitazone, owing to concerns that the overall risks of rosiglitazone and pioglitazone exceed their benefits. A third, troglitazone, was the first drug in this class to be marketed but was removed from the market in both the United States and United Kingdom because it caused liver dysfunction and, in some patients, liver failure.

The pharmacology and use of thiazolidinediones will be reviewed here. Biguanides (only metformin is currently available) and other oral hypoglycemic drugs are discussed separately:

(See "Initial management of blood glucose in adults with type 2 diabetes mellitus".)

(See "Management of persistent hyperglycemia in type 2 diabetes mellitus".)

(See "Metformin in the treatment of adults with type 2 diabetes mellitus".)


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Literature review current through: Apr 2017. | This topic last updated: Apr 27, 2017.
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