Rationale for and role of thiazolidinediones in type 2 diabetes mellitus

• Published in: The American journal of cardiology 2002-09, Vol.90 (5), p.34-41
• Main Author: Lebovitz, Harold E
• Format: Article
• Language: English
• Subjects: Administration, Oral; Biological and medical sciences; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Drug therapy; General and cellular metabolism. Vitamins; Humans; Hyperlipidemias - etiology; Hyperlipidemias - prevention & control; Hypoglycemic Agents - therapeutic use; Insulin; Insulin Resistance; Islets of Langerhans - cytology; Islets of Langerhans - drug effects; Medical sciences; Metabolic Syndrome - drug therapy; Pharmacology. Drug treatments; Thiazoles - therapeutic use
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(02)02557-2

Several classes of antihyperglycemic agents are available for the treatment of patients with type 2 diabetes. These agents, including thiazolidinediones, biguanides, insulin secretagogues, α-glucosidase inhibitors, and insulin, offer differing mechanisms of actions and can be used either alone or in combination. The thiazolidinediones are a newer class of oral antidiabetic agents that improve glycemic control and may preserve β-cell function. Clinical trial data suggest that patients with type 2 diabetes experience progressive deterioration of β-cell function. By decreasing insulin resistance, thiazolidinediones may preserve β-cell function, and patients may experience prolonged glycemic control. The thiazolidinediones also exert beneficial effects on dyslipidemia, endothelial function, coagulation, and blood pressure. By improving these components of the metabolic syndrome, thiazolidinediones may reduce the incidence of both microvascular and macrovascular complications. This article provides an overview of the role of thiazolidinediones in the treatment of type 2 diabetes.