Thiazolidinediones for Initial Treatment of Type 2 Diabetes?

Abstract

The twin epidemics of obesity and type 2 diabetes mellitus have spawned a public health crisis. In the United States, an estimated 1.5 million new cases of diabetes occur every year,1 and the projected microvascular and cardiovascular complications2 — already the greatest cause of blindness, kidney failure, and amputations in the Western world, and a substantial contributing factor in heart disease — are likely to become the major cause of preventable disease and premature death in this millennium. The gravity of this epidemic is reflected by evidence-based efforts to stem it.3,4 Moreover, in the United States, approval of five . . .