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Significant Weight Gain With Rezulin Therapy
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A 62-year-old man developed type 2 diabetes mellitus circa 1994. He was initially treated with glyburide and then with insulin. After rezulin (initial dosage, 200 mg/d; later dosage, 400 mg/d) was added to the regimen,the percentage of glycosylated hemoglobin decreased from 9.5% to 6.7% (reference range, 4.1%-6.1%). Four months after the patient started taking 400 mg/d of rezulin, he began to develop peripheral edema and his waist circumference increased. Despite the initiation of furosemide therapy (40 mg/d), he gained a total of 20 kg over approximately 4 months.
He was admitted to the hospital because of increasing peripheral edema and shortness of breath. The physical examination revealed that the patient weighed 150 kg, that his blood pressure was normal, and that he had chronic atrial fibrillation. There were no rales or S3 gallop. There was 3 to 4+ pitting edema of the lower extremities, as well as stasis dermatitis.
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