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Troglitazone in type II diabetes mellitus
1Department of Pharmacy Practice, Wilkes University, Wilkes-Barre, Pennsylvania 18766, USA.
Pharmacotherapy
|June 10, 1998
Summary
Troglitazone enhances insulin sensitivity for type II diabetes, offering potential benefits like reduced insulin needs. However, its limited advantages over other treatments and risks necessitate careful patient selection and monitoring.
Area of Science:
- Pharmacology and Therapeutics
- Endocrinology and Metabolism
Background:
- Troglitazone is an antihyperglycemic agent for type II diabetes mellitus.
- It improves insulin sensitivity rather than stimulating insulin secretion.
Purpose of the Study:
- To evaluate the potential advantages and disadvantages of troglitazone.
- To determine its place in therapy for type II diabetes mellitus.
Main Methods:
- Review of available information on troglitazone's efficacy and safety.
- Comparison with existing oral antihyperglycemic agents and insulin.
Main Results:
- Potential benefits include decreased insulin requirements and reduced hypoglycemia risk.
- Disadvantages include cytochrome P450 induction, risk of liver injury, and higher cost.
- Limited demonstrated benefit over sulfonylureas or metformin in monotherapy or combination.
Conclusions:
- Troglitazone offers an alternative mechanism for glycemic control by enhancing insulin sensitivity.
- Its use should be reserved for patients with poor glycemic control on high-dose insulin pending further comparative studies.
- Routine monitoring of serum transaminases is crucial due to rare idiosyncratic hepatocellular injury.