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The European medicines regulator (EMEA) warned in 2007 that a newer diabetes drug, rosigilazone, should not be given to patients with a history of a heart attack, or patients with ischaemic heart, or peripheral arterial, diseases. Rosigiltazone and a similar medication, pioglitazone, belong to a class of drug known as glitazones.

Recently, the British Drug and Therapeutics Bulletin (DTB) reports that glitazones offer no real advantage over other diabetes drugs. DTB suggest that glitazones have a place in combined treatments with either metformin or a sulphonylurea for patients with type 2 diabetes who are unsuited to one or other of these older drugs. However, they found weak evidence for the use of glitazones in triple therapy, and they should be reserved for patients where insulin is not recommended or poorly tolerated.

DTB concludes that pioglitazone is probably the safer option of the two glitazones, but should still not be used in anyone at high risk of heart failure. Although, pioglitazone is licensed for use with insulin treatment, DTB says that this combination carries the risk of weight gain, oedema, and potential heart failure.

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