Fluid retention with thiazolidinediones in diabetic heart failure

Thiazolidinediones are new insulin sensitizers that have the propensity to cause fluid retention and therefore have been contraindicated in patients with advanced heart failure. We studied III consecutive diabetic patients with heart failure and observed a 17.1% incidence of developing a predominantly peripheral, reversible form of fluid retention. There was no direct association between the risk of fluid retention and the baseline degree of heart failure severity. Nevertheless, thiazolidinedione use should be in the differential diagnosis of any diabetic patient with decompensated heart failure.