Diabetes is characterized by insufficient production of insulin and insulin resistance of skeletal muscle cells. Diabetes drugs help manage levels of blood glucose, a sugar used by the body for energy. Edema is swelling of the hands, arms, feet and legs caused by excess fluid trapped in the tissues of the body that can be caused by certain diabetes drugs, according to MayoClinic.com.
Thiazolidinediones
Thiazolidinediones are a class of drug that treats Type 2 diabetes. Research conducted by S. Mudaliar and published in "Endocrinology Practice" in 2003 reviewed the incidence, pathophysiology and clinical significance of edema in association with thiazolidines in patients with Type 2 diabetes. The research found that the incidence of edema ranges from 3.0 to 7.5 percent with thiazolidinediones compared with 1.0 to 2.5 percent with placebo or other oral diabetes drugs. When thiazolidinediones are used with insulin, the incidence of edema ranges from 14.7 to 15.3 percent compared with a range of 5.4 to 7.0 percent for insulin only. The research concluded that thiazolidinedione-associated edema is dose-related and occurs most frequently when used in combination with insulin.
Pioglitazone
Pioglitazone hydrochloride is the active pharmaceutical ingredient in Actos, a brand name prescription drug that is indicated as an adjunct to diet and exercise to improve glycemic control in adults with Type 2 diabetes, according to its product label. Pioglitazone is a thiazolidinedione that decreases insulin resistance. The product label warns that the drug can cause or exacerbate congestive heart failure, including excessive edema, and should be used with precaution in patients with edema. Furthermore, the product label says that the most common side effects from the drug include upper respiratory tract infection, headache, inflammation of the sinus, muscle pain, tooth disorder and inflammation of the pharynx.
Rosiglitazone
Rosiglitazone is the active pharmaceutical ingredient in Avandia, a brand name prescription drug indicated as an adjunct to diet and exercise to improve glycemic control in adults with Type 2 diabetes mellitus, according to its product label. The product label warns users that the drug is a thiazolidinedione and can increase risk for edema. Side effects from rosiglitazone include upper respiratory tract infection, injury, headache, back pain, high blood sugar, fatigue, inflammation of the sinus and diarrhea. The U.S. Food and Drug Administration announced on Sept. 23, 2010 that it will restrict the use of Avandia to patients with Type 2 diabetes who cannot control their diabetes on other medications. The decision was based on risks of heart attack and stroke.
References
- MayoClinic.com: Edema
- "Endocrinology Practice"; Thiazolidinediones, Peripheral Edema, and Type 2 Diabetes; Mudaliar, S.; Sep-Oct 2003
- "Diabetes Research and Clinical Practice"; Thiazolidinediones and Risk of Edema; Berlie, H.D.; May 2007
- Takeda Pharmaceuticals: Actos Prescribing Information
- GlaxoSmithKline: Avandia Prescribing Information
