Using thiazolidinediones: rosiglitazone and pioglitazone in clinical practice

Am J Manag Care. 2001 Apr;7(3 Suppl):S87-95; quiz S96-7.


Type 2 diabetes is a disorder that has numerous components, including insulin resistance, an insulin secretory defect, and an increase in hepatic glucose production. Until recently, only the insulin secretory defect could be treated. Within recent years, the thiazolidinedione (TZD) class of drugs, which targets primarily insulin resistance, was released. Originally developed in Japan as triglyceride-lowering agents, TZDs were found to be more effective in lowering blood glucose levels instead. The actions of 2 TZDs--rosiglitazone and pioglitazone--are discussed, and their glucose- and nonglucose-lowering effects are explained. Four case histories are presented to illustrate various patients' responses to TZDs in clinical practice. Although TZDs have been demonstrated to be effective in dealing with many different aspects of type 2 diabetes, further study, involving multiple clinical trials, is needed.

Publication types

  • Review

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Education, Continuing
  • Female
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use
  • Insulin Resistance
  • Male
  • Middle Aged
  • Pioglitazone
  • Polycystic Ovary Syndrome / drug therapy
  • Thiazoles / therapeutic use*
  • Thiazolidinediones*
  • United States


  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin
  • Thiazoles
  • Thiazolidinediones
  • 2,4-thiazolidinedione
  • Pioglitazone