Thiazolidinedione

In medicine, thiazolidinediones are "thiazoles with two keto oxygens. Members are insulin-sensitizing agents which overcome insulin resistance by activation of the peroxisome proliferator activated receptor gamma (PPAR-gamma)." Thiazolidinediones are used for the treatment of diabetes mellitus type 2. Examples in include rosiglitazone and pioglitazone.

Effectiveness
The initial choice of anti-diabetic drug has been compared in a randomized controlled trial which found "cumulative incidence of monotherapy failure at 5 years of 15% with rosiglitazone, 21% with metformin, and 34% with glyburide."

Pioglitazone, an insulin sensitizer, may reduce atherosclerosis compared to sulfonylureas which are insulin secretagogues.

Cardiac
Rosiglitazone may increase risk of death from cardiovascular causes.

Rosiglitazone had more weight gain and edema. Thiazolidinediones may increase the risk of heart failure.

Fractures
Long term use of thiazolidinediones may double the risk of fractures in women.