Pioglitazone, SU, and insulin are now third- and fourth-line agents due to the associated weight gain, risk of hypoglycaemia, and need for SMBG with insulin and SU.

People with type 2 diabetes requiring third- or fourth-line therapy

Reserve pioglitazone, sulfonylureas, and insulin for third- or fourth-line use because of weight gain, hypoglycemia, and monitoring burden

Use as earlier-line therapy

Glycemic control balanced against weight gain, hypoglycemia, and self-monitoring burden