In 1997, the medical community was prescribing a new drug to treat type 2 diabetes. By March 2000, this drug was removed from the market because it was causing hepatitis and liver disease. Drugs in this family are still being prescribed to treat diabetes. Are there any risks?

Troglitazone was allegedly a miracle drug. It decreased incidence of type 2 diabetes by up to 75% compared with a control group. It helped relieve many complications that can come from insulin resistance, including certain ovarian diseases. It was prescribed to use with insulin, with other diabetes medications, and by itself for therapy. Only after 3 years did the FDA (Food and Drug Administration) realize that troglitazone caused severe liver damage. Troglitazone was available under the brand names Rezulin and Romozin.

Troglitazone is in the thiazolidinedione family of diabetes medications. The thiazolidinedione family includes pioglitazone and rosiglitazone. Pioglitazone is marketed as Actos by Takeda Pharmaceuticals; Rosiglitazone is marketed as Avandia by GlaxoSmithKline. Both of these medications are currently on the market.

Neither Avandia nor Actos have been associated with an increase in liver disease. However, both of these medications may cause an increase risk of heart attack and stroke. It is important that you discuss any concerns that you have with your doctor before undertaking any treatment.

Both Avandia and Actos can be used as monotherapies (by themselves) to help increase the body's sensitivity to insulin. They can also be used with insulin treatment, for type 2 diabetics who are insulin dependent. Avandia and Actos can be used in combination with other diabetes medications, such as biguanides (such as metformin) and sulfonylureas. Avandia is available in pre-mixed combinations called Avandamet and Avandaryl.

In order to minimize your risk of side effects on diabetes medication from the thiazolidinedione family, such as Actos and Avandia, it is important to follow your doctor's directions. This means that you will have to follow your diet and exercise regimen. It also means that you will have to limit your alcohol intake.

You will not be able to take a thiazolidinedione if you have a history of liver disease, or if you have a history of heart disease.

Doctors typically monitor patients' livers when they are on Avandia, Actos, or other thiazolidinedione because of the previous scare with Rezulin. Your liver function can be monitored with regular blood tests, often each month or every other month. Be sure to visit your health care professional regularly to have your check ups.

The basic element of diabetes management, no matter your treatment, is keeping a healthy diet and exercise. This can often prevent you from having to take medications to treat your diabetes, or it can help you minimize the amount of medication that you need. Prevention is often the best medicine of all.