First introduced in the late 1990s for treatment of type 2 diabetes, thiazolidinediones are in the class of glitazones, an oral diabetes drug that decreases insulin resistance, while also treating hyperglycemia. The drug makes liver and skeletal muscle tissues more sensitive to the actions of insulin, increasing glucose absorption. The diabetes thiazolidinediones (pioglitazone and rosiglitazone) are sold as Actos and Avandia. They are also combined with other diabetes drugs, under the brand names of Duetact, Actoplus Met, and Avandamet. How these medicines work is not fully understood, but they aren’t able to produce more insulin. Instead, they help the body’s cells to use what insulin there is by lowering resistance. In the treatment of diabetes, thiazolidinediones should not be one’s first choice, as there can be serious side effects and a few of these drugs have been restricted by the U.S. Food and Drug Administration (FDA). They should only be used when other treatments have failed to lower blood sugar to a healthy range.
Thiazolidinediones Side Effectsa and Restrictions: What You Need to Know
Side effects that have been reported after using thiazolidinediones include headaches and mild anemia, cold and flu-like symptoms, muscle pain, fluid retention and weight gain. Rezulin, one of the thiazolidinediones, was taken off the market for causing severe liver damage. There may still be some risk in the newer drugs. Signs of liver damage include stomach pain, nausea and vomiting, loss of appetite, fatigue, and jaundice. In 2010, the FDA restricted access to Avandia and Avandamet, for use only by type 2 diabetics who have not been able to control their glucose with other medicines, and cannot use Actos. This is because of findings that show a heightened risk of heart attack and stroke. Those who are at risk of heart failure or liver disease should not use any of the diabetes thiazolidinediones, nor should children and pregnant women. In June of 2011, Actos was removed from the market in France and Germany, due to the risk of bladder cancer in patients taking the drug for two years or longer. There have also been reports of heart failure and blindness. The FDA has implemented new labeling requirements to address these concerns.
Thiazolidinediones Alternatives: What Are Your Options?
In treating type 2 diabetes, thiazolidinediones are only recommended when other treatments have failed. There are many alternatives. The American Diabetes Association (ADA) briefly discusses the six classes of diabetes drugs on their website (http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/oral-medications/what-are-my-options.html). However, many would say that lifestyle changes – a healthy diet, daily exercise and weight reduction – is all a person needs to maintain balanced blood sugar levels and reduce symptoms and complications of diabetes. In fact, medical professionals will always say that any diabetes treatment must begin with a healthy diet and exercise. So before considering medications that pose such serious health risks, first have a close look at your lifestyle choices.
