Pioglitazone is a thiazolidinedione hypoglycemic drug that acts mainly through activation of peroxisome proliferator-activated receptor γ (PPARγ), increasing the sensitivity of target tissues to insulin action and lowering blood glucose. It promotes fat redistribution and shifts adipose tissue from visceral to subcutaneous tissue, possibly related to its role in increasing insulin sensitivity. Pioglitazone can be used alone or in combination with other hypoglycemic agents for the treatment of type 2 diabetes mellitus, especially in obese individuals with significant insulin resistance. Adverse reactions to pioglitazone include anemia, mild-to-moderate edema, hypoglycemic reactions, hepatic function abnormalities, macular edema, lipid changes, and fractures. Note that the drug is contraindicated in people who are allergic to the product, have a history of bladder cancer, or have unexplained hematuria of the naked eye. Pioglitazone should be used in strict accordance with doctor’s instructions.