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Updated: Jul 9, 2026
10:03
A Zebrafish Model of Diabetes Mellitus and Metabolic Memory
Published on: February 28, 2013
[Therapy with glitazones--a risk for cardiovascular disease?]
D Rottlaender1, G Michels, E Erdmann
1Klinik III für Innere Medizin, Universitätsklinikum Köln, Köln.
Deutsche Medizinische Wochenschrift (1946)
|December 1, 2007
Summary
Thiazolidinediones improve glycemic control in type-2-diabetes. However, rosiglitazone may increase cardiovascular risk, while pioglitazone might be a safer option for high-risk patients without heart failure.
Area of Science:
- Endocrinology
- Pharmacology
- Cardiology
Background:
- Thiazolidinediones are effective in reducing glucose levels and HbA1c in type-2-diabetes by enhancing insulin sensitivity via PPAR-gamma activation.
- Concerns exist regarding the cardiovascular safety of rosiglitazone, a thiazolidinedione, prompting a re-evaluation of its use.
Purpose of the Study:
- To review recent studies and meta-analyses on thiazolidinediones, focusing on the cardiovascular risks associated with rosiglitazone therapy.
- To provide guidance for clinicians regarding the use of rosiglitazone in type-2-diabetes management.
Main Methods:
- Systematic review of published studies and meta-analyses concerning thiazolidinediones and cardiovascular outcomes.
- Analysis of clinical trial data, including the PROactive study, and meta-analysis findings.
Main Results:
- Thiazolidinediones can cause fluid retention, making them contraindicated in patients with heart failure (NYHA I-IV).
- Pioglitazone demonstrates beneficial effects on lipid profiles (lower triglycerides, higher HDL), whereas rosiglitazone may elevate LDL cholesterol.
- The PROactive study showed no significant effect on the primary endpoint but reduced secondary cardiovascular endpoints in high-risk patients. Conversely, meta-analyses suggest an increased risk of cardiovascular events with rosiglitazone.
Conclusions:
- Rosiglitazone use should be reconsidered due to potential cardiovascular risks.
- Pioglitazone may be preferred for managing type-2-diabetes in high-risk individuals without heart failure, considering its lipid profile benefits and the PROactive study findings.
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