Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What potential side effect should be monitored when prescribing thiazolidinediones?

1. Weight neutrality

2. Glycemic excursions

3. Fluid retention

4. Gastrointestinal disturbances

The correct answer is: Fluid retention

When prescribing thiazolidinediones, it is essential to monitor for fluid retention because these medications can cause the body to retain fluid, leading to edema or swelling. This side effect arises due to the mechanism by which thiazolidinediones act; they improve insulin sensitivity, which can also lead to an increase in sodium reabsorption and fluid accumulation in tissues. Monitoring for fluid retention is crucial, especially in patients who may have existing heart conditions or those at risk for heart failure, as excessive fluid can exacerbate these issues. It's also important to recognize that fluid retention can result in unintended weight gain, making it a significant concern during treatment. While weight neutrality, glycemic excursions, and gastrointestinal disturbances are associated with diabetes medications, they are not the primary concerns with thiazolidinediones compared to fluid retention, which is a distinct and well-documented side effect.