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Efficacy and Cardiovascular Safety of Thiazolidinediones

[ Vol. 16 , Issue. 2 ]


Arkiath Veettil Raveendran*, Cornelius James Fernandez and Koshy Jacob   Pages 233 - 249 ( 17 )


Type 2 diabetes mellitus (T2DM) is characterized by a progressive beta cell dysfunction in the setting of peripheral insulin resistance. Insulin resistance in subjects with type 2 diabetes and metabolic syndrome is primarily caused by an ectopic fat accumulation in the liver and skeletal muscle. Insulin sensitizers are particularly important in the management of T2DM. Though thiazolidinediones (TZDs) are principally insulin sensitizers, they possess an ability to preserve pancreatic β-cell function and thereby exhibit durable glycemic control. Cardiovascular outcome trials (CVOTs) have shown that Glucagon-like-peptide 1 receptor agonists (GLP-1 RAs) and sodium glucose transporter-2 inhibitors (SGLT2i) have proven cardiovascular safety. In this era of CVOTs, drugs with proven cardiovascular (CV) safety are often preferred in patients with preexisting cardiovascular disease or at risk of cardiovascular disease. In this review, we will describe the three available drugs belonging to the TZD family, with special emphasis on their efficacy and CV safety.


Pioglitazone, rosiglitazone, glycemic control, heart failure, cardiovascular disease, insulin resistance.


Department of Internal Medicine, Badr Al Samaa group of hospitals, Barka, Department of Endocrinology and Metabolism, Pilgrim Hospital, Boston,PE21 9QS, Department of Endocrinology and Metabolism, Eastbourne Hospital, Eastbourne, BN21 2UD

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