Current Diabetes Reports

, Volume 13, Issue 3, pp 329–341 | Cite as

The Future of Thiazolidinedione Therapy in the Management of Type 2 Diabetes Mellitus

  • Hanford Yau
  • Kathya Rivera
  • Romina Lomonaco
  • Kenneth CusiEmail author
Pharmacologic Treatment of Type 2 Diabetes and Obesity (A Vella, Section Editor)


Since their approval, thiazolidinediones (TZDs) have been used extensively as insulin-sensitizers for the management of type 2 diabetes mellitus (T2DM). Activation of peroxisomal proliferator-activated receptor gamma (PPARγ) nuclear receptors by TZDs leads to a vast spectrum of metabolic and antiinflammatory effects. In the past decade, clinicians and scientists across the fields of metabolism, diabetes, liver disease (NAFLD), atherosclerosis, inflammation, infertility, and even cancer have had high hopes about the potential for TZDs to treat many of these diseases. However, an increasing awareness about undesirable “off-target” effects of TZDs have made us rethink their role and be more cautious about the long-term benefits and risks related to their use. This review examines the most relevant work on the benefits and risks associated with TZD treatment, with a focus on the only PPARγ agonist currently available (pioglitazone), aiming to offer the reader a balanced overview about the current and future role of TZDs in the management of insulin-resistant states and T2DM.


Thiazolidinedione Peroxisomal proliferator-activated receptor-γ Pioglitazone Rosiglitazone Type 2 diabetes mellitus Insulin resistance Dyslipidemia Nonalcoholic fatty liver disease Nonalcoholic steatoh epatitis Polycystic ovarian syndrome 


Conflict of Interest

Hanford Yau serves as a certified insulin pump trainer for Medtronics, Inc.

Kathya Rivera declares that she has no conflict of interest.

Romina Lomonaco declares that she has no conflict of interest.

Kenneth Cusi has received study medication only for a controlled trial from Takeda Pharmaceuticals U.S.A.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Hanford Yau
    • 1
  • Kathya Rivera
    • 1
  • Romina Lomonaco
    • 1
  • Kenneth Cusi
    • 1
    Email author
  1. 1.Division of Endocrinology, Diabetes and MetabolismDepartment of Medicine, The University of Florida North Florida/South Georgia Veterans Health SystemGainesvilleUSA

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