I just took an AMA CME on some problems that have been discovered with the use of Actos

Take this to your doctor if you suspect that you may be experiencing any type of discomfort and you are on Actos.

""Pioglitazone HCl Tablets (Actos) Linked to Risks for Heart Failure
On February 25, the FDA approved safety labeling revisions for pioglitazone HCl tablets (Actos; Takeda Pharmaceutical Co Ltd) that include new data regarding the risk for macrovascular disease.

As with other thiazolidinediones, pioglitazone can cause fluid retention, potentially leading to or exacerbating heart failure. Data from the Prospective Pioglitazone Clinical Trial in MacroVascular Events (PROactive) of 5238 patients with type 2 diabetes and a prior history of macrovascular disease has revealed an increased risk for heart failure with use of 45 mg/day of pioglitazone (n = 2633) vs placebo (5.7% vs 4.1%). The mortality rate associated with serious heart failure was similar between groups (1.5% [n = 40] vs 1.4% [n = 37]).

The FDA also advised healthcare professionals regarding postmarketing reports of macular edema, sometimes accompanied by peripheral edema, in patients receiving pioglitazone and other thiazolidinediones. Some patients presented with blurred vision or decreased visual acuity, whereas others appear to have been diagnosed during routine ophthalmic examinations. Although the causal role of thiazolidinediones remains unclear, some patients experienced amelioration of their macular edema following discontinuation of therapy.""

If they are having this much problems with this why don't they just take it off the market period? Instead of relying on people to find out on their own that for some it may not be good

Avandia has also been recently linked to an increase in heart related issues.

*However* since people with Type 2 diabetes are already at a high risk for heart disease, simply stopping a medication such as this may do more harm than good. So, I have to point out that no one should stop taking any medications without first talking to their doctor. You may be able to switch medications and still get good control, but only your doctor can say what's best for you.

My personal opinion is to only take medications that you really *need*. If you are early on in your Type 2 diabetes, and have not tried to get good control with diet, exercise, and weight loss, these options should be explored before you move on to medication, which always runs the risk of side effects.

Note that I am NOT saying to reject medication when it is needed, just that lifestyle changes alone can help some (but not all) people with early Type 2 diabetes to remain medication free, or at least delay the need. Each patient needs a "harm/benefit" ratio.

If your doctor hands you a pile of prescriptions for pills, ask him if lifestyle changes could give you the same results. Often, doctors simply think that people would *rather* take the pills than change how they live. We know that this is not the case. Most of the Type 2 diabetics here have worked VERY hard to improve their health.

The truth is, we simply don't have enough long-term data on many of the newer drugs out there to say that they are safe 100%. Does that mean stop taking them? Not necessarily. New medications and advances in technology help people live healthier lives more often than not. But we DO need to always make sure that we really need all medications we take and that any risks of the unknown are worth the benefit.

If anyone is still concerned, please ask your doctor about switching over to one of the "older" tried, tested ,and true Type 2 diabetes medications. Please note that these also may have side effects, but none that are this serious in nature.

P.S. Look at these studies with a critical eye. They need to be replicated before we can actually say for certain what (if any) the link is here. There can be alternative explanations for these outcomes. But in the meantime, I would talk to your doctor about medication alternatives if possible.

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Pre-Med Student

I agree don't make any major movies until you know it's right for you. You have to make sure that its something that NOT cause you more complications.