Because Avandia cannot cause insulin to be produced in the body, it cannot be used alone to treat type 1 diabetes. Avandia, however, may be used to treat people who have had type 1 diabetes for many years and who have become insulin-resistant as they have aged. People with type 1 diabetes who are not insulin-resistant should not take Avandia -- the medication cannot cause you to be more sensitive to insulin when there is no insulin present in the body.
In September 2010, the U.S. Food and Drug Administration (FDA) announced that it was severely restricting the use of Avandia, due to the risk of "cardiovascular events" such as heart attacks and strokes. Only individuals who could not control their diabetes on other medications (or those who were already taking the medication and doing well) would be able to take Avandia.
However, in November 2013, the FDA announced that a careful analysis of the research suggests that there is not, in fact, any increased risk, compared to treatment with standard diabetes medications and that the use of this medication will no longer be restricted.
How Does Avandia Treat Diabetes?
Avandia works by decreasing insulin resistance, which occurs when the body becomes resistant to the effects of insulin, and is common in people with type 2 diabetes. In type 2 diabetes, the pancreas produces large amounts of insulin in an attempt to make up for insulin resistance. In type 1 diabetes, however, the pancreas cannot produce any insulin at all.
Because Avandia cannot cause insulin to be produced, it cannot be used alone to treat type 1 diabetes. In other words, it does no good to increase sensitivity to insulin if there is no insulin present in the body.
However, people may have both types of diabetes at the same time. Often, these are people who have had type 1 diabetes for many years and have become insulin-resistant as they have aged. Although these people still need insulin, they might also benefit from a medication that decreases insulin resistance, such as Avandia. This might allow them to use less insulin.
However, the idea of "double diabetes" is relatively new, and more research is needed in this area before the best treatments are known.
Written by/reviewed by: Kristi Monson, PharmD;Arthur Schoenstadt, MD
Last reviewed by: KristiMonson, PharmD;
List of references (click here):
Avandia [package insert]. Research Triangle Park, NC: GlaxoSmithKline;2011 February.
Food and Drug Administration, Center for Drug Evaluation and Research. FDA Drug Safety Communication: FDA requires removal of some prescribing and dispensing restrictions for rosiglitazone-containing diabetes medicines (November 25, 2013). FDA Web site. Available at: http://www.fda.gov/Drugs/DrugSafety/ucm376389.htm. Accessed December 20, 2013.
Food and Drug Administration, Center for Drug Evaluation and Research. Avandia (rosiglitazone): REMS - risk of cardiovascular events (9/23/2010). FDA Web site. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm226994.htm. Accessed October 1, 2010.
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