not provide a complete picture of diabetes in Latinos of pre-diabetes (blood glucose. levels above normal but subthreshold for diabetes) (Harris et al. …
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Impact of Diabetes Medications on Cardiovascular Health
Type 2 diabetes is a life-long disease caused by high levels of sugar in the blood It occurs when the body does not respond correctly to insulin, a hormone released by the pancreas Insulin is needed to move glucose blood sugar into cells, where it is used for energy If glucose does not get into the cells, the body cannot use it for energy When too much glucose remains in the blood, symptoms of diabetes, such as thirstiness and frequent urination, occur Type 2 diabetes, the most common form of diabetes, is associated with insulin resistance This means that, although the pancreas produces insulin, the body does not respond to insulin by moving glucose into fat and muscle cells Since the cells are not getting the sugar they need, the pancreas produces more and more insulin Many people with insulin resistance have high levels of sugar and high levels of insulin in the blood at the same time People with type 2 diabetes can usually control their blood sugar by watching their diet and taking oral medications It is important to monitor and carefully control blood sugar because,
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INFORMATION
American Diabetes Association wwwdiabetesorg/type-2-diabetesjsp
Medline Plus wwwnlmnihgov/medlineplus/ency/article/000313htm National Diabetes Information Clearinghouse http://diabetesniddknihgov/dm/pubs/diagnosis/
over time, uncontrolled diabetes leads to blindness, kidney failure, and nerve damage, as well as heart and vascular disease Individuals with type 2 diabetes are 24 times more likely to die from a heart attack or stroke than are people without diabetes Diabetes also increases the risk of clogged arteries and heart failure Thiazolidinediones also known as glitazones are one type of oral medicine used by people with type 2 diabetes to lower their blood sugar The glitazone drugs pioglitazone Actos and rosiglitazone Avandia help move glucose out of the blood and into the cells that need it In addition to lowering blood sugar, these medications may have other actions They may act as antioxidants, possess antiinflammatory effects, prevent blockage in blood vessels, alter cholesterol levels, and reduce blood pressure Despite the benefits of glitazones on blood sugar, some research has suggested that these drugs may have unwanted effects on the heart Recent studies
show that glitazones can cause
Based on Thiazolidinediones in Type 2 Diabetes 
: A Cardiology Perspective by Ujjaini Khanderia, Rodica Pop-Busui, and Kim A Eagle, The Annals of Pharmacotherapy, October 2008, http://dxdoiorg/101345/aph1K666 For Our Patients is provided by The Annals to help explain the latest research and information relating to your medications These summaries are for informational purposes only and are not a substitute for professional advice from your personal medical provider If you have questions about this material, you should discuss it with your physician or pharmacist This summary may be reproduced without permission for not-for-profit educational purposes only Any other use must be approved by the publisher Copyright 2008, Harvey Whitney Books Company, wwwhwbookscom FOPE14 DOI 101345/fop1K666
fluid to be retained by the body–often beginning with swollen ankles This can worsen or even cause heart failure It is more likely to occur with higher doses of glitazones and is more common in patients who also take other medicines for diabetes such as metformin Glucophage, glipizide Glucotrol, glyburide Diabeta, Micronase, or insulin Most of the time, fluid
retention associated with the use of glitazone drugs goes away quickly once the drugs are stopped Because of the risk of fluid retention, however, individuals with serious heart failure termed class III or IV conditions should not take glitazones Other studies have found that rosiglitazone may slightly increase the risk of heart attacks Pioglitazone, on the other hand, may decrease the risk of heart attack This may be related to
the drugs different effects on cholesterol levels Compared with pioglitazone, which reduces triglyceride levels, rosiglitazone increases triglyceride levels Pioglitazone also has better effects on LDL bad cholesterol and HDL good cholesterol compared with rosiglitazone If you take a glitazone drug for your diabetes, you should talk to your healthcare provider immediately if you gain more than 6 pounds within a short period of time It could be a sign that you are retaining fluid Other signs of water retention are swollen ankles or difficulty breathing, especially at night Until we know more about the cardiovascular effects of glitazone drugs, if you take glitazones and are reaching your blood sugar goals, you should continue taking your medication as
prescribed, as long as you are not experiencing any complications
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