Thiazolidinediones and clinical outcomes in type 2 diabetes.

摘要

Type 2 diabetes is characterised by two main metabolic defects: target-cell resistance to the action of insulin (insulin resistance) and insufficient secretion of insulin by pancreatic beta cells (beta-cell dysfunction).1 Thiazolidinedione medications (rosiglitazone and pioglitazone), through modulation of the transcription factor peroxisome proliferator-activated receptor gamma, have remarkable beneficial effects on both insulin action and beta-cell function The clinical significance of these effects is underscored by the fact that treatment with thiazolidinediones results in more durable glycaemic control compared with other antidiabetic agents (especially sulfonylureas). Furthermore, the thiazolidinediones have several other beneficial cardio-metabolic effects, including reduction of visceral fat mass, decreased systemic inflammation, and improvement in biomarkers and surrogate outcomes associated with atherosclerosis