Thiazolidinediones and Cardiovascular Disease: Balancing Benefit and Harm

Sonal Singh, MD; Yoon K. Loke, MD


Geriatrics and Aging. 2008;11(3):179-183. 

In This Article


Based on the available evidence, we recommend that newly diagnosed patients with type II diabetes not be assigned a thiazolidinedione. Individuals with type II diabetes who have heart failure or a history of heart failure should not be prescribed thiazolidinediones and should be switched to alternative regimens. Rosiglitazone should be avoided in persons with cardiovascular disease (angina, MI), and these patients should be switched to alternative regimens. Current patients with poor glycemic control taking the thiazolidinediones should be switched immediately to alternative agents such as metformin and insulin. Even for those who are well controlled on the thiazolidinediones, strong consideration should be given to alternative regimens that do not include a thiazolidinedione. In the case where a clinician has exhausted other therapeutic options, pioglitazone may be the preferred thiazolidinedione.


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