MEDizzy - Pioglitazone can be used as a second- or third-line therapy

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Diabetes and Lipid Metabolism

Pioglitazone can be used as a second- or third-line therapy when glycaemic control remains poor, especially in presence of a significant degree of insulin resistance, although the use of this agent has been associated with complications such as congestive cardiac failure.\ All of the following complications are associated with pioglitazone use except?

ExplanationD. Pioglitazone and rosiglitazone are thiazolidinedione compounds, which act as peroxisome proliferator-activated receptors γ-agonists and help reduce peripheral insulin resistance. There is an increased incidence of heart failure in patients on pioglitazone therapy, with the risk of fluid retention. Pioglitazone has also been linked with a small increased risk of bladder carcinoma, and should not be used in patients with risk factors for bladder cancer and unexplained haematuria. The liver function needs to be monitored for the patients on pioglitazone therapy. There are case reports linking the development of macular oedema with the use of pioglitazone therapy. This agent has also been associated with an increased risk of fractures. Rosiglitazone use was also associated with increased cardiovascular risks and it was withdrawn from the market on 2010, following a review by European Medicines agency