Abstract
To evaluate the effect of thiazolidinediones on the development of cardiac failure and pulmonary edema during treatment of type 2 diabetes mellitus. We retrospectively reviewed the medical records of 6 men (aged 66 to 78 years) treated at our institution between August 1, 2001, and May 21, 2002, who had type 2 diabetes and developed signs and symptoms of congestive heart failure and pulmonary edema after 1 to 16 months of therapy with pioglitazone or rosiglitazone. Four patients had chronic renal insufficiency; only 1 had ischemic cardiomyopathy. Symptoms resolved promptly in all 6 patients after administration of diuretics and discontinuation of the thiazolidinedione. We conclude that thiazolidinediones can cause or exacerbate heart failure and pulmonary edema and should be avoided in patients with left ventricular dysfunction or chronic renal insufficiency.
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