Diabetes Self-Management Blog

It hasn’t been a very good year for Type 2 diabetes drug rosiglitazone (brand name Avandia). First, in December and January, studies came out linking the drug to an increased risk of bone fractures in women (see “Diabetes Drug Linked to Fracture Risk”). Then, in May, the drug made headlines when an analysis of multiple studies found a link between rosiglitazone and increased risk of heart attack (see “Type 2 Drug Avandia Linked to Increased Risk of Heart Attacks”). Now two more studies have been published, one of which links the drug to a slew of adverse effects and the other of which ties it to an increased risk of cancer in women.

The first study, published on July 18 in The Cochrane Library (the journal of an international, not-for-profit organization that reviews medical research), examined 18 past trials of rosiglitazone that involved more than 8,000 participants. The analysis, performed by researchers in Germany, concluded that rosiglitazone was not any more effective at lowering HbA1c levels than other oral diabetes drugs and did not provide any additional benefits in areas such as length of life, quality of life, or drug cost. What’s more, its documented side effects included double the risk of edema (swelling), weight gain of up to 11 pounds, increased risk of cardiovascular disease (heart disease and stroke), and bone fractures in women.

This analysis was conducted independently of the review of multiple studies published in May that linked rosiglitazone with increased heart attack risk.

Another study published recently in the journal BMC Medicine looked at the relationship between the use of thiazolidinediones, the class of diabetes drugs to which rosiglitazone belongs, and the occurrence of cancer. Researchers interviewed a selection of about 1,000 people with diabetes about their health, including any history of cancer. They found that people who took thiazolidinediones had a 59% increased risk of cancer, even after they controlled for factors such as age, body-mass index, smoking, HbA1c level, other diabetes drugs used, and total number of prescription drugs used. After further analysis, the researchers found that rosiglitazone was associated with an 89% increased risk of cancer, whereas the risk associated with the other drug in the thiazolidinedione class, pioglitazone (Actos), was not statistically significant. They also found that the association with cancer was statistically significant only in women.

Meanwhile, a third study, published online on July 16 in the journal Annals of Internal Medicine, examined more than 200 published trials of various oral diabetes drugs and found that several older diabetes drugs are just as safe and effective as newer, more expensive diabetes drugs. For instance, metformin (brand name Glucophage and others), which is available generically, effectively lowers HbA1c levels without causing weight gain or hypoglycemia, and it also helps lower LDL, or bad, cholesterol levels. Thiazolidinediones rosiglitazone and pioglitazone, on the other hand, trigger weight gain and raise LDL cholesterol levels. Consumer Reports, which published a consumer guide to the study results, also recommended the sulfonylurea drugs glipizide (Amaryl) and glimepiride (Glucotrol) as “Best Buys” for safety, effectiveness, and value. You can read a summary of the guide here.

It is important to keep in mind that all diabetes drugs have side effects. Any changes in your drug regimen should be decided upon by you and your health-care provider based on your individual needs and medical history. In the case of rosiglitazone, additional studies have shown conflicting data about some of the drug’s proposed side effects, and absolute risks associated with the drug are small. (For instance, in the review published in May, out of a group of nearly 28,000 study subjects there were 14 more heart attacks in people taking rosiglitazone than in those taking another drug or a placebo.) The FDA’s advisers have scheduled a meeting on July 30 to discuss rosiglitazone’s safety, and DiabetesSelfManagement.com will keep you posted with breaking news as this situation continues to evolve.


  1. Would the combination of Metformin, avandia and Glimipiride cause a weight gain that does not go away?

    Posted by orangediabetic |
  2. Hi orangediabetic,

    Different diabetes drugs have different side effects, and several have been shown to cause weight gain, including rosiglitazone (Avandia) and glimepiride, a sulfonylurea. For more information about different Type 2 diabetes oral drugs and their side effects, you may want to read our article “Oral Medicines for Type 2 Diabetes.”

    Posted by Tara Dairman, Web Editor |
  3. I have been taking Actos since some years. I am concerned but as my endocrologist has prescribed a combination treatment of Actos, Amaryl and metfin, I was mad to understand that the risk was less . Please keep me posted on new research findings on Avandia and Actos.

    Posted by Padma De Mello |
  4. Unfortunately Actos has been linked to an increased risk of heart attack, heart failure, and death. It has also been linked to an increased risk of bladder cancer, rhabdomyolysis, liver damage, and bone fracture. Is it possible a prescription for a healthier diet and some exercise could help?

    -Marilyn G

    Posted by Marilyn |
  5. i want to ask about another alternative to this class of drugs ?

    Posted by lamia |

Post a Comment

Note: All comments are moderated and there may be a delay in the publication of your comment. Please be on-topic and appropriate. Do not disclose personal information. Be respectful of other posters. Only post information that is correct and true to your knowledge. When referencing information that is not based on personal experience, please provide links to your sources. All commenters are considered to be nonmedical professionals unless explicitly stated otherwise. Promotion of your own or someone else's business or competing site is not allowed: Sharing links to sites that are relevant to the topic at hand is permitted, but advertising is not. Once submitted, comments cannot be modified or deleted by their authors. Comments that don't follow the guidelines above may be deleted without warning. Such actions are at the sole discretion of DiabetesSelfManagement.com. Comments are moderated Monday through Friday by the editors of DiabetesSelfManagement.com. The moderators are employees of Madavor Media, LLC., and do not report any conflicts of interest. A privacy policy setting forth our policies regarding the collection, use, and disclosure of certain information relating to you and your use of this Web site can be found here. For more information, please read our Terms and Conditions.

Type 2 Diabetes
Discovering I Had Type 2 Diabetes (10/17/14)
Low-Carb Diet Improves Quality of Life in Type 2 Diabetes (10/07/14)
Long Hours at Low-Income Jobs Linked to Increased Diabetes Risk (10/02/14)
Metformin Study Currently Recruiting (08/19/14)

Oral Medicines
Statins May Reduce Risk of Nerve Damage, Other Diabetes Complications (09/18/14)
New Metformin Combo Drug Approved for Type 2 Diabetes (08/13/14)
FDA Approves New Oral Drug for Type 2 Diabetes (08/07/14)
New SGLT Drugs Coming (07/23/14)

Diabetes Research
Can Grapefruit Juice Prevent Weight Gain, Increase Insulin Sensitivity? (10/16/14)
Low-Carb Diet Improves Quality of Life in Type 2 Diabetes (10/07/14)
Long Hours at Low-Income Jobs Linked to Increased Diabetes Risk (10/02/14)
Statins May Reduce Risk of Nerve Damage, Other Diabetes Complications (09/18/14)

Diabetes News
FDA Approves Remote Glucose-Monitoring Technology (10/24/14)
Can Grapefruit Juice Prevent Weight Gain, Increase Insulin Sensitivity? (10/16/14)
Low-Carb Diet Improves Quality of Life in Type 2 Diabetes (10/07/14)
Long Hours at Low-Income Jobs Linked to Increased Diabetes Risk (10/02/14)



Disclaimer of Medical Advice: You understand that the blog posts and comments to such blog posts (whether posted by us, our agents or bloggers, or by users) do not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs. The opinions and other information contained in the blog posts and comments do not reflect the opinions or positions of the Site Proprietor.