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Thiazolidinediones
The
thiazolidinediones, which are a relatively recent development in the treatment
of Type 2 diabetes, take a new approach to the condition that many clinicians
believe is closer to its underlying causes. In most people suffering from this
type of diabetes, there may be higher-than-normal levels of insulin, because the
pancreas is secreting more in an attempt to compensate for high blood glucose
levels. The problem is that the cells have developed an insulin resistance,
which means that they do not respond insulin in the way they should. The
thiazolidinediones address this resistance by improving the cell's response to
glucose.
These drugs, which
are also known as glitazones, accomplish this by altering the metabolism of
fatty acids so that they do not compete with glucose for metabolism in the cell.
To affect fatty acid metabolism, they target cell receptors called peroxisome
proliferator activated receptors (PPARs).
In May 2007, the FDA released a safety alert on rosiglitazone (brand name: Avandia) which stated there may be a potentially significant increase in the risk of heart attack and heart-related deaths in persons taking this drug. They have instructed these individuals (especially those who already have heart disease or those who are at high risk for developing heart disease) to talk to their doctor about this new information so an individualized plan can be made regarding these findings. The FDA is continuing to look into all available data on this topic and will report their findings once their research is completed.
Drugs in the class
Pioglitazone (Actos)
Rosiglitazone (Avandia) | 
