The Oral Insulin Sensitizer, Thiazolidinedione, Increases Plasma Vascular Endothelial Growth Factor in Type 2 Diabetic Patients

Thiazolidinediones, insulin sensitizers, are widely used for the treatment of insulin resistance in type 2 diabetic patients. One of the adverse effects is fluid retention. We evaluated the effect of pioglitazone, a thiazolidinedione, on plasma vascular endothelial growth factor (VEGF) in comparison with that of metformin in type 2 diabetic patients. A 4-week administration of pioglitazone significantly increased plasma VEGF levels, whereas levels were unchanged by metformin. The results suggest that thiazolidinediones may increase plasma VEGF levels, possibly one of the causes of the drug-induced fluid retention and edema. Type 2 diabetes is characterized by fasting hyperglycemia caused by increased insulin resistance with or without decreased insulin secretion (1). Appropriate weight reduction and physical exercise in obese type 2 diabetic patients are useful in reducing the insulin resistance in these patients. Thiazolidinediones are a widely used class of drugs for the treatment of insulin resistance in type 2 diabetic patients (2). Two of …