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Curr Diab Rep. 2013 Jun;13(3):329-41. doi: 10.1007/s11892-013-0378-8.

The future of thiazolidinedione therapy in the management of type 2 diabetes mellitus.

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1
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The University of Florida North Florida/South Georgia Veterans Health System, Gainesville, Florida, USA.

Abstract

Since their approval, thiazolidinediones (TZDs) have been used extensively as insulin-sensitizers for the management of type 2 diabetes mellitus (T2DM). Activation of peroxisomal proliferator-activated receptor gamma (PPARĪ³) nuclear receptors by TZDs leads to a vast spectrum of metabolic and antiinflammatory effects. In the past decade, clinicians and scientists across the fields of metabolism, diabetes, liver disease (NAFLD), atherosclerosis, inflammation, infertility, and even cancer have had high hopes about the potential for TZDs to treat many of these diseases. However, an increasing awareness about undesirable "off-target" effects of TZDs have made us rethink their role and be more cautious about the long-term benefits and risks related to their use. This review examines the most relevant work on the benefits and risks associated with TZD treatment, with a focus on the only PPARĪ³ agonist currently available (pioglitazone), aiming to offer the reader a balanced overview about the current and future role of TZDs in the management of insulin-resistant states and T2DM.

PMID:
23625197
DOI:
10.1007/s11892-013-0378-8
[Indexed for MEDLINE]
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