Insulin resistance both precedes and predicts type 2 diabetesmellitus.1 Although exercise and weight loss ameliorate insulinresistance and may in some cases prevent or delay onset of thedisease,2 therapy that combats insulin resistance in those whofail to change their lifestyle is needed. Current pharmacologicapproaches are unsatisfactory in improving such consequencesof insulin resistance as hyperglycemia, diabetic dyslipidemia,abnormal coagulation and fibrinolysis, and hypertension,3 eachof which may require the use of at least one medication. Thus,the development of drugs targeted to reverse insulin resistanceis important. The insulin-sensitizing thiazolidinediones, whichare selective ligands of the . . . [Full Text of this Article]
The Superfamily of Peroxisome-Proliferator–Activated Receptors
Mechanism of Action of Thiazolidinediones
Insulin Sensitivity and Secretion
Enhancement of Insulin Sensitivity
Indirect Effects in Adipose Tissue
Clinical Efficacy of Thiazolidinediones in Humans
Effects in Patients with Type 2 Diabetes
Hypoglycemic Effects
Effects on Lipids
Effects of Thiazolidinediones on Conditions Characterized by Insulin Resistance
Nonalcoholic Fatty Liver Disease
Polycystic Ovary Syndrome
Lipodystrophies
Effects of Thiazolidinediones on Markers of Cardiovascular Risk
Body Composition and Blood Pressure
Plasma and Urinary Markers
Vascular Function and Disease
Safety and Tolerability of Thiazolidinediones
Weight Gain, Fluid Retention, and Anemia
Hepatotoxicity
Insulin Sensitization beyond Thiazolidinediones
Conclusions
Source Information
From the Division of Diabetes, Department of Medicine, University of Helsinki, Helsinki.
Address reprint requests to Dr. Yki-Järvinen at the Division of Diabetes, Department of Medicine, P.O. Box 340, 00029 HUS Helsinki, Finland, or at ykijarvi@cc.helsinki.fi.
Related Letters:
Thiazolidinediones
Davidson M. B., Edelman S. V., Mascitelli L., Pezzetta F., Yki-Järvinen H.
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N Engl J Med 2005;
352:205-207, Jan 13, 2005.
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