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Sugar Matters
April 11, 2008

Diabetes medication: Meet the Glitazones

Fellow Vincies, I hope you are all well and hanging on with me on this road. I am sure some of these weeks of going over the medications may be a bit boring to you. I promise to spice it up again soon!

The “glitazone” group of medications is small and includes Rosiglitazone(also called Avandia) and Pioglitazone(Actos). In the world of medications they would be considered “middle-aged” as they have not been around as long as Metformin, but are no longer considered “new”.{{more}} There are many scientific studies showing their strengths. For instance, there is research showing that the amount of plaque in heart arteries decreased while patients took one of these medications.

The Glitazones work by improving insulin sensitivity, so they make YOUR OWN insulin work better but they do not make any new insulin. They are used not only for diabetes but also other situations where you need to improve how insulin is working, for example in a disorder called polycystic ovary syndrome. Some doctors are also using it for insulin resistance syndrome or the metabolic syndrome but this is not completely agreed upon by the medical community.

In terms of side effects, because these medications do not cause increases in insulin production they are very unlikely to cause low blood sugars when used alone. However, when ADDED to other diabetes pills or insulin they can cause low sugars, so you still need to be watchful. The common side effects include weight gain and some swelling in the feet. Those of you with heart problems should be VERY cautious with these medications, and your doctor should know about your heart function before thinking about starting you on these medicines. The other folks who need to be careful are those with liver problems because these medications can make them worse or better, all depending on the cause of the problem. A little known fact is that people with weak bones also need to be careful on these medicines because there is some suggestion that they could have some effect on bone strength as well.

Some of you are probably asking, “Wait, wasn’t there a big stink in the news last year about one of these medications?” Yes, you got me there. Last year a big research group had some results that showed that people taking Rosiglitazone had more heart problems that those who did not take it. There was a big rush from patients all over the place asking their doctors if they should stop the medication. Right now the general consensus is that this medication can still be used but cautiously, and not at all in some patients—so if you have a very high risk for heart problems, this is not a good medication for you.

Hopefully I have not scared you about this group because they are still good options in our small arsenal of diabetes medicines. If you are taking one of them and have qeustions, as always ask your doctor,nurse or pharmacist and get the answers you need!

Next week we’ll talk about some of the newest agents on the market, a very exciting group of medicines(I know, I am a big nerd. But they ARE exciting, really…)

Take care, Vincies!

Anita Ramsetty, MD
endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227

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