PMID- 17468147
OWN - NLM
STAT- MEDLINE
DCOM- 20070621
LR  - 20190101
IS  - 1079-2082 (Print)
IS  - 1079-2082 (Linking)
VI  - 64
IP  - 9
DP  - 2007 May 1
TI  - Thiazolidinediones in patients with type 2 diabetes mellitus and heart failure.
PG  - 931-6
AB  - PURPOSE: A review of the significant findings related to the use of the 
      thiazolidinediones (TZDs) in the treatment of patients with type 2 diabetes 
      mellitus and heart failure was conducted. SUMMARY: TZDs are antihyperglycemic 
      medications that increase insulin sensitivity and improve the underlying defect 
      of insulin resistance and type 2 diabetes mellitus, and they have the potential 
      to slow or decrease the cardiovascular damage that results from these conditions. 
      TZDs are also implicated in weight gain; however, this is accompanied by an 
      improvement in insulin sensitivity and, therefore, its clinical significance is 
      unclear. Edema has been well characterized in patients treated with TZDs. Edema 
      is more common in patients treated with a TZD in combination with insulin and 
      higher doses of TZDs. Because of the potential for fluid retention and worsening 
      edema, clinical studies have excluded patients with New York Heart Association 
      (NYHA) functional class III or IV heart failure. In patients at risk for heart 
      failure or those who have NYHA functional class I or II symptoms, initiation of 
      therapy should be at the lower dose for TZDs with close monitoring of weight 
      gain, edema, and other signs of worsening heart failure. CONCLUSION: Current data 
      suggest that TZDs may be used cautiously in patients with type 2 diabetes 
      mellitus who are at risk for heart failure or who have NYHA functional class I or 
      II heart failure. Patients with NYHA functional class III or IV heart failure 
      should not receive TZDs.
FAU - Granberry, Mark C
AU  - Granberry MC
AD  - Department of Pharmacy Practice, University of the Incarnate Word, School of 
      Pharmacy, San Antonio, TX, and Central Arkansas Veterans Healthcare System, 
      Little Rock, AR 72205, USA.
FAU - Hawkins, Jason B
AU  - Hawkins JB
FAU - Franks, Amy M
AU  - Franks AM
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Am J Health Syst Pharm
JT  - American journal of health-system pharmacy : AJHP : official journal of the 
      American Society of Health-System Pharmacists
JID - 9503023
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Thiazolidinediones)
SB  - IM
CIN - Am J Health Syst Pharm. 2007 Dec 1;64(23):2426-30; author reply 2430. PMID: 
      18029947
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Edema/chemically induced
MH  - Heart Failure/complications/*drug therapy
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects/pharmacology/*therapeutic use
MH  - Insulin/metabolism
MH  - Insulin Resistance
MH  - Risk Factors
MH  - Thiazolidinediones/adverse effects/pharmacology/*therapeutic use
MH  - Weight Gain/drug effects
RF  - 39
EDAT- 2007/05/01 09:00
MHDA- 2007/06/22 09:00
CRDT- 2007/05/01 09:00
PHST- 2007/05/01 09:00 [pubmed]
PHST- 2007/06/22 09:00 [medline]
PHST- 2007/05/01 09:00 [entrez]
AID - 64/9/931 [pii]
AID - 10.2146/ajhp060446 [doi]
PST - ppublish
SO  - Am J Health Syst Pharm. 2007 May 1;64(9):931-6. doi: 10.2146/ajhp060446.