In people with type 2 diabetes, a group of drugs called thiazolidinediones, including pioglitazone, can silently damage the heart. These pills can cause fluid buildup, leg swelling, and even congestive heart failure, especially in people over 60.
Even more concerning, these pills can mask early symptoms of heart failure, such as fatigue or shortness of breath. Seniors with diabetes are already at high risk for heart disease, and adding a medication that strains the heart becomes a dangerous combination.