Thiazolidinediones (TZDs) are a commonly-used therapy for the treatment of insulin resistance in Type 2 diabetes.
TZDs are often used in combination with sulfonylureas, metformin, or both. They act to reduce insulin resistance by producing more fat cells. The cells produced are more sensitive to insulin and have a higher chance of being used to process glucose. This process has been shown to lower A1C scores by varying amounts in studies. Currently, the most popular TZD prescribed is the generic brand, pioglitazone.
There has been some controversy surrounding this drug’s reported side effects. TZDs were introduced during the 1990s. After the first generation of the drug was linked to serious liver damage, efforts were made to correct the issue.
A popular TZD called Avandia (rosiglitazone) fell out of favor when some studies indicated it came with serious cardiac risks; it is still in use, just not often prescribed. Since then, there has been other studies linking TZDs to heart failure. Researchers with the American Heart Association concluded that if a person has a preexisting condition affecting the heart, TZDs may affect cardiac muscle.