[Insulin sensitizer drugs, XXXX : current state and prospect].

@entity1 @entity137 @entity6 @entity28 @entity4506 @entity12585 @entity12098 @entity310 @entity12721 @entity164 @entity413 @entity6864
@entity164 2 @entity6 is characterized by decreased secretion of insulin and insulin resistance. @entity12721 are drugs to ameliorate insulin resistance. At present, only @entity12098 is available in Japan. The first drug of this category, @entity4506 , has been withdrawn from market because of its liver @entity137 in a few @entity1 . The decrease in fasting plasma @entity413 begins within 2 weeks and reaches the nadir in 8-12 weeks. Plasma insulin levels usually decrease together with plasma @entity413 . @entity12585 drugs are effective in about 50% of type 2 @entity6 @entity1 . The efficacy is higher in @entity1 with @entity28 , high insulin levels and in aged @entity1 and females. The mechanism is thought to be mediated by activation of a nuclear receptor, @entity6864 , which is most abundantly expressed in the adipose tissue. Current concept is that, when @entity6864 is activated by these drugs, the number of small adipocytes is increased to replace large adipocytes, thereby decreasing the release of @entity310 and FFA from adipose tissue. However, there seems to be a complex relationship between the activity of @entity6864 and insulin sensitivity. The effect of these new category drugs should be monitored carefully on a long-term basis.
