Understanding Contemporary Use of Thiazolidinediones An Analysis From the Diabetes Collaborative Registry

Background: Thiazolidinediones (rosiglitazone, pioglitazone) are oral insulin-sensitizing medications used in type 2 diabetes mellitus that reduce glucose with minimal risk of hypoglycemia and potential benefits on atherosclerosis. However, thiazolidinediones can cause fluid retention thereby increasing the risk of heart failure-a common complication of type 2 diabetes mellitus. Methods and Results: Data were analyzed from the Diabetes Collaborative Registry, a US outpatient registry of patients with type 2 diabetes mellitus that currently encompasses 203 cardiology, endocrinology, and primary care practices and 3074 providers. Among 424 061 US adults enrolled in Diabetes Collaborative Registry who had type 2 diabetes mellitus and were taking >= 1 glucose-lowering medication, 35 018 patients (8.3%) were on a thiazolidinedione, which has remained stable over time. Patients on thiazolidinediones tended to be old (mean age, 69.2 +/- 10.7 years), 61.9% had coronary disease, and 17.2% had class 3 obesity. In total, 40.3% of patients on a thiazolidinedione had either a clinical diagnosis of heart failure (23.7%), had an ejection fraction of