Glitazones in type 2 diabetes: an update

doi:10.1136/dtb.2008.03.0008

Drug and Therapeutics Bulletin 2008;46:25-29; doi:10.1136/dtb.2008.03.0008

Glitazones in type 2 diabetes: an update

Relevant BNF section: BNF 6.1.2.3

The glitazones and their combination products are licensed fortype 2 diabetes mellitus and now account for over 50% of NHSexpenditure on oral hypoglycaemic drugs.¹ In 2001, for ${blacktriangledown}$ pioglitazoneand rosiglitazone (the two glitazones licensed in the UK), weconcluded that evidence (from short-term studies) supportedtheir use in combination with metformin or a sulphonylurea inpatients unsuited to one or other of these drugs, but not morepractical glitazone use, such as monotherapy or as part of tripletherapy.² We also said that their long-term effects were notyet clear.² Since then, both drugs have also been licensed formonotherapy, as part of triple therapy that includes metforminand a sulphonylurea and, for pioglitazone, use with insulin.^3,4Here we reassess glitazones in light of published efficacy dataand safety concerns raised in recent years.