Sulfonylureas andthiazolidinediones effectively reduce blood glucose and [HbA.sub.1c] levels, and may be used as add-on therapy in patients with T2D who do not achieve targets with metformin alone.

Pharmacological agents like metformin,thiazolidinediones and alpha-glucosidase inhibitors have also demonstrated the potential to delay progression to diabetes and may be considered in those individuals with high risk of progression to diabetes and increased cardiovascular risk.

The researchers found that the risk of acute pancreatitis was not increased comparing 49,374 DPP-4I initiators with 132,223 sulfonylurea initiators (weighted hazard ratio, 1.01; 95 percent confidence interval, 0.83 to 1.24) and comparing 57,301 DPP-4I initiators with 32,612thiazolidinedione initiators (weighted hazard ratio, 1.11; 95 percent confidence interval, 0.76 to 1.62).

Hinds, "Deciphering the Roles ofThiazolidinediones and PPAR y in Bladder Cancer," PPAR Research, vol.

Understanding the structure of PPAR as the molecular target forthiazolidinediones, its functions in glucose and lipid metabolism, and nature of the binding interactions between PPAR and their agonists are indispensable for the discovery and design of new antidiabetic drugs.

Tuccori and his colleagues studied 145,806 patients with newly diagnosed type 2 diabetes, defined as a first-ever prescription forthiazolidinediones, metformin, sulfonylureas, prandial glucose regulators, acarbose, dipeptidyl peptidase-4 inhibitors, glucagonlike peptide agonists, or sodium-glucose cotransporter-2 inhibitors.

Thiazolidinediones carry a risk of bone fractures, bladder cancer, and, of special concern, cardiovascular side effects [4].

Sulfonylurea therapy was started by 3,570 patients (23 percent), 948 patients (6.1 percent) began treatment withthiazolidinediones and 2,034 patients (13.1 percent) with DPP-4 inhibitors.

Thiazolidinediones have been used to check the inhibitory effect of TNF-[alpha] on the differentiation of 3T3-Ll adipocytes cells.

Thethiazolidinediones have emerged as effective agents for antidiabetes and anti-inflammation [7].

Thiazolidinediones (TZD) are a class of pharmaceutical agents currently used in the treatment of type-2 diabetes mellitus; they are also known as adipogenic compounds (Furrnsinn and Waldhausl, 2002).

In particular, it is not known whether newer classes of drugs for T2DM such as thethiazolidinediones (TZDs) will have beneficial effects and only a few studies are done or are underway to answer this question and one of the most recent one is the PROactive study .