Thiazolidinedione Use, Fluid Retention, and Congestive Heart Failure: a consensus statement from the American Heart Association and American Diabetes Association: Response to Elasy and Griffin

We appreciate the letter from Elasy and Griffin (1) containing their approach to the use of thiazolidinediones (TZDs). The goal of our re-port (2) was to increase awareness of this potentially serious side effect of TZD use. Our recommendations were based on the evidence we reviewed and discussed. We do not disagree with the opinions expressed by Elasy and Griffin and believe that these decisions are always best made by the provider, carefully weighing all of the potential benefits and risks of these medications in their particular patient. We should state that there are many scenarios with individual patients in whom cardiac disease may have been clinically evident or is present at the time TZDs are being considered. The consensus document could not consider all of these and instead aimed to provide the practitioner with general guidelines. The authors of this letter have appropriately come to their own conclusions about the use of TZDs in selected patients with diabetes.