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Feature Article

Getting to know the glitazones

Andrew Lowy, Pat Phillips

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Abstract

The ‘glitazones’ are a new class of compounds for the treatment of type 2 diabetes. They exert their glucose-lowering effect by improving the sensitivity of the peripheral tissues to insulin. They are active alone and in combination with other oral antidiabetic agents and with insulin.

Key Points

  • The glitazones are a new class compounds for the treatment of type 2 diabetes that exert their glucose-lowering effect by improving the sensitivity of peripheral tissues to insulin.
  • A large part of their action appears to be mediated through changes in body fat and its distribution; they also affect adipocyte hormone production (particularly adiponectin), which may result in additional favourable biological effects.
  • Rosiglitazone and pioglitazone are listed on the PBS for use in patients with type 2 diabetes as monotherapy and in combination with sufonylureas, metformin, or both, where blood sugar levels are not controlled with lifestyle measures.
  • Pioglitazone is subsidised also for combination therapy with insulin.
  • The main adverse effect of the glitazones is weight gain, and an important class effect is fluid retention, causing peripheral oedema in 3 to 5% of patients.

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