Thiazolidinediones (TZDs) improve hyperglycemia by improving insulin resistance and by maintaining or improving beta-cell secretory function.
Side effects
“One of the side effects of TZDs is that they can cause fluid retention, especially in patients with cardiac and renal disease. This may lead to weight gain and peripheral edema. Because of this effect, TZDs are contraindicated in patients with New York Heart Association class III or IV heart failure.
They can also reduce bone mineral density and are associated with a higher risk of non-osteoporotic bone fractures. In addition to their ability to decrease glucose levels, however, there have been some other favorable effects noted with their use.
Clinical trials have shown that treatment with pioglitazone resulted in a significant reduction in the composite outcome of nonfatal acute myocardial infarction, stroke, and all-cause mortality.” ABFM