Thiazolidinediones
Among the newest remedies for diabetes, thiazolidinediones (THIGH-ah-ZO-li-deen-DYE-owns) help a patient's body become more sensitive to insulin by using the hormone better and producing less sugar. There are two types of thiazolidinediones: pioglitazone (brand name: Actos) and rosiglitazone (Avandia). These medications, which are relatively pricey, may slightly raise HDL ("good") cholesterol.
Potential side effects: The first drug in this class, troglitazone (Rezulin), was pulled off the market because it led to serious liver problems in a small number of people. To date, the two available thiazolidinediones on the market have not shown the same problems, but patients are still closely monitored for liver trouble as a precaution. Thiazolidinediones are not recommended for people with congestive heart failure. Both may cause swelling of the feet or lower legs. And one of them, Avandia, may increase the risk of heart attack.
Concerns specific to older adults: Water retention isn't good for an older adults with heart or liver disease. If a patient is at risk of either, his doctor may prescribe these medications at a lower dose or prescribe them to be taken every two days to avoid this problem. Due to the potential higher risk of heart attack from Avandia, San Francisco endocrinologist Alan Rubin, author of Diabetes for Dummies, says he only prescribes Actos to his older patients.
