Related Experiment Video
Updated: Jun 24, 2026

Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes
Published on: March 7, 2025
Controversies in type 2 diabetes - An update
1School of Medicine and Pharmacology, University of Western Australia, and Head, Department of Endocrinology and Diabetes, Fremantle Hospital, Western Australia. byeap@cyliene.uwa.edu.au
Background:
Controversy has emerged concerning the risks associated with glitazone therapy in type 2 diabetes, specifically bone fracture and myocardial infarction. Results from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study have stimulated debate about appropriate glycated haemoglobin (HbA1c) targets.
Objective:
This article examines the context for glitazone therapy in patients with type 2 diabetes, the risks associated with pioglitazone and rosiglitazone, and arguments for targeting HbA1c at the threshold of 7%.
Discussion:
Pioglitazone and rosiglitazone can be employed as oral therapy in patients with type 2 diabetes and preserved endogenous insulin secretion. Potential benefits and risks of each agent should be considered. An acceptable initial target for HbA1c is 7%. Lowering HbA1c to 6.5% did not reduce macrovascular complications in patients with type 2 diabetes, but did reduce new or worsening nephropathy. Aggressive therapy aiming to lower HbA1c to <6% in patients with type 2 diabetes at especially high risk of cardiovascular disease may lead to a higher risk of mortality.
Related Concept Videos
Diabetes Mellitus: Type 2 and Gestational
Type II Diabetes II: Pathophysiology
Type II Diabetes I: Introduction
Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type I Diabetes II: Pathophysiology
Carbohydrate Metabolism
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in the...