Thiazolidinediones

Background

Thiazolidinediones (TZD ) also known as glitazones  were discovered by researchers from  Takenda Chemical Industries  in Japan .The researchers were looking at medications that lower triglycerides (common fats found in the body) ,when they notice that substance with a thiazolidine in their chemical structure improved insulin resistance in rats.

This led to the discovery and registration of Pioglitazone ,Troglitazone and Rosiglitazone. Troglitazone  and Rosiglitazone were later withdrawn from the market  due to  liver problems and  increased risk of heart attacks.

 Pioglitazone is the only TZD available in South Africa.

How does Pioglitazone work ?

Pioglitazone  helps improve insulin  resistance by increasing cells sensitivity to insulin . The medication has also been shown to lower amounts of glucose released by the liver.

Factors to consider when using Pioglitazone.

Risk of  hypoglycaemia

Pioglitazone has a low risk for hypoglycaemia. The use of pioglitazone together with other glucose lowering medications increases risk of hypoglycaemia.

Glycaemic effect

Pioglitazone lowers  HbA1c  by 0.9 to 1.7% .

Effect on weight

Pioglitazone causes moderate weight gain. Weight gain associated with Pioglitazone ranges between 2-4 kg. Weight gain is affected by does of pioglitazone prescribed.

Benefits to heart and kidneys  

Pioglitazone has been shown to positively affect  cholesterol levels by lowering  LDL (bad cholesterol) and Triglycerides (fats) while increasing  HDL (good cholesterol).This is important for heart health.

Cost

The cost of pioglitazone is within reach of many living with Type 2 Diabetes.

Side Effects

Common side effects associated with Pioglitazone include :

  • Water retention
  • Swelling
  • Brittle bones (Osteoporosis)

Bladder cancer is a rare side effect associated with Pioglitazone.

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