Rosh Internal Medicine Boost Practice Exam

Thiazolidinediones (TZDs) are a class of medications that help manage hyperglycemia in individuals with type 2 diabetes by primarily increasing insulin sensitivity. They work through the activation of peroxisome proliferator-activated receptors (PPAR-gamma), which enhances the effectiveness of insulin in peripheral tissues, particularly in muscle and adipose tissue. This action helps lower blood glucose levels by improving how the body responds to insulin.

In contrast to TZDs, biguanides like metformin primarily work by reducing hepatic glucose production and improving insulin sensitivity, but their mechanism is different from that of TZDs. Sulfonylureas, on the other hand, function by stimulating the pancreas to release more insulin, addressing blood glucose levels through increased insulin secretion rather than sensitivity. Aminoguanidine is not a first-line treatment for diabetes and is not used for managing blood glucose levels; rather, it was studied for other conditions.

Thus, TZDs specifically enhance insulin sensitivity, making them a vital option in the management of type 2 diabetes.