Medical Encyclopedia

Polycystic ovary syndrome is an endocrine disorder and one of the causes of infertility in women of childbearing age. This is a hormone disorder which results in a condition when a woman's ovaries do not release an egg once a month as they should. Patients with this syndrome usually have characteristic symptoms of obesity, abnormal bleeding, severe acne, excessive hair growth or hair loss.

It is typical of women with polycystic ovary syndrome to be insulin resistant. Thus, this disease is concomitant to diabetes type 2. And one of the major features of polycystic ovary syndrome is hyperinsulinemia which in a compensatory manner accompanies the development of insulin resistance.

Diabetic nephropathy is considered to be the leading cause of end-stage renal disease. Cardiovascular risks and diabetic nephropathy are known to be closely linked. And the annual cardiovascular death rates are considerably higher in patients with microalbuminuria. Apart from microalbuminuria, other factors that accelerate the progression of diabetic nephropathy to end-stage renal disease include poor glycemic control, high blood pressure, obesity, smoking, and genetic susceptibility.

Microalbuminuria is the first unmistakable symptom of diabetic nephropathy. It can be also a sign of target organ damage. Lowering blood pressure and normalizing glucose levels can reduce microalbuminuria. In this way Avandia containing Rosiglitazone simultaneously reduces the excretion of albumin in the urine or arrests it all together and decreases high blood pressure significantly. Thus, it is of vital importance that Avandia proves capable of reducing urinary albumin excretion in type 2 diabetes.

Being a thiazolidinedione, Avandia can bring forth fluid retention which in its effect can cause heart failure or exacerbate it. Heart failure is a special medical condition when the heart does not pump blood well enough throughout the body. The impaired heart's pumping ability leads to the buildup of fluid, known as edema, in the feet, legs and ankles as well as tiredness and shortness of breath. If the condition is pronounced enough, the main objective is to prevent the development of acute decompensated heart failure.

Many patients with diabetes type 2 are prescribed sulfonylurea medicines as their first-line therapy. Sulfonylureas represent the oldest class of anti-diabetic agents. Effective as they remain, the problem with these medicines is that they do not directly treat insulin resistance. Therefore, over time they may lose their effectiveness.

The combination of Avandia with sulfonylureas is aimed at delivering a more powerful effect on the symptoms of diabetes mellitus over time in patients who appear to be inadequately controlled while on sulfonylureas alone. What is really important is that this combination therapy has proved to bring a sustained effect over a long period of time.

The combination of different anti-diabetic agents has become a well-established medical practice in diabetes therapy, especially when it is really difficult to reach the stage of diabetes compensation taking one medicine. In this line of developing possible ways of treating diabetes type 2 different combinations of anti-diabetic agents have been worked out and tried. The one that has proved effective, and that is therefore a common medical practice nowadays, is the combination of Avandia and Metformin.