Journal of Medicine Vol 4 - Amrita Institute of Medical Sciences and ...

Amrita Journal of Medicine
Cases, Evidence and Verdicts- The Glitazone Controversy
What would be reasonable conclusions to draw from
these varying results?
1. Thiazolidinediones are approved monotherapy agents
in treatment of type 2 diabetes mellitus. They are also
indicated for use in combination with sulfonylurea,
metformin, or insulin when diet and exercise plus the
single agent does not result in adequate glycemic control.
However they should be used cautiously, if at
all, in those with cardiovascular disease.
2. They may be used in those with IFG/IGT with high
risk of diabetes.
3. Pioglitazone would clearly seem to be preferable to
rosiglitazone in view of its favorable lipid lowering
profile and less cardiovascular events and can be considered
the agent of choice if a thiazolidinedione is
required.
4. The treating clinician should carefully consider the
need for any thiazolidinedione before prescribing one
and should refrain from using rosiglitazone in the absence
of exceptionally compelling circumstances.
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14 Clifford J. Rosen, M.D. The Rosiglitazone Story — Lessons from
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