Thiazolidinedione use, fluid retention, and congestive heart failure. Circulation 108

D iabetes is a chronic, progressivelyworsening disease associated with avariety of microvascular and mac-rovascular complications. Cardiovascular disease (CVD) is the main cause of death in these patients (1,2). During the past decade, numerous drugs have been intro-duced for the treatment of type 2 diabetes that, used in monotherapy or in combina-tion therapy, are effective in lowering blood glucose to achieve glycemic goals and in reducing diabetes-related end-organ disease. Two such drugs, rosiglitazone and pioglitazone, belong to the class called thiazolidinediones (TZDs) (3). Troglita-zone, the first agent of this class to be ap