Question 874

Feb 25, 2017

Which one of the following categories of glucose-lowering drugs improves insulin resistance as its primary mechanism of action?


Answer: B. Thiazolidinediones (e.g. pioglitazone)   (TZD's)

Explanation: Biguanides and thiazolidinediones are the two classes of hypoglycemia drugs that improve insulin resistance as their primary mechanism of action. Thiazolidinediones are thought to act on adipose tissue, muscle, and the liver to reduce glucose production and increase glucose use. They may also preserve pancreatic beta-cell function, thereby improving blood glucose levels. Thiazolidinediones are generally combined with other drugs, for example, metformin, in patients who do not respond to monotherapy. However, they are rather costly and should not be prescribed to patients with a history of heart failure or low bone density.


Nathan DM, et al. Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy: A consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2009;32:193-203.