Fluid retention (oedema) may occur and can lead to congestive heart failure so, a combination of use with insulin and use in heart failure may increase the risk in patients taking PIOGLITAZONE. You should not take PIOGLITAZONE if you have kidney disease, as measured by a blood test. PIOGLITAZONE, when used with or without insulin, $ name tends to lower the blood sugar level. So, the doctor may lower the dose of insulin. Increased fractures may be reported in some women taking PIOGLITAZONE. Patients with bladder cancer and macular oedema (fluid build-up in the macula part of the retina of the eye) should consult the doctor before using PIOGLITAZONE.

Drug-Drug Interactions: PIOGLITAZONE may interact with antidiabetics (gemfibrozil), and antibiotics (rifampicin). So, tell your doctor if you are using these drugs before taking PIOGLITAZONE.

Drug-Food Interactions: Taking PIOGLITAZONE with alcoholic beverages may increase the risk of a rare but serious and potentially life-threatening condition known as lactic acidosis (build-up of lactic acid in the blood) and hypoglycaemia.

Drug-Disease Interactions: PIOGLITAZONE should be avoided in patients with congestive heart failure (heart-related issues), type I diabetes, bladder cancer, oedema, liver disease, macular oedema, premenopausal anovulation, obesity (weight gain), anaemia as it may worsen the condition.

• Fill your half plate with starchy veggies, a quarter with proteins, and a quarter with whole grain.
• Eat at regular interval. Do not take the long gap between a meal or snack.
• Monitor your blood sugar level regularly especially when there are a lot of fluctuations.
• Invest at least 150 min of moderate-intensity physical activity and 15 minutes of high-intensity exercise every week.
• Lose weight gradually to achieve a healthy body mass index (18.5 to 24.9).
• Replace refined carbohydrates containing foods with whole grain foods and increase intake of fruits and veggies and other fibre enriched foods.
• Reduce intake of saturated fat (or hidden fats) in the food like chips, crisps, pastries, biscuits and samosas. Choose omega 3 fatty acid-containing oils for daily cooking. For frying, you may use palm oil, mustard oil, groundnut oil, rice bran oil, and safflower oil.
• Do not take stress as it may elevate your blood sugar level. You may adopt stress management techniques like mindfulness, yoga or meditation to control stress-related to blood sugar changes.
• Opt for low-fat dairy products (low-fat yoghurt, fat-free milk and cheese etc.).
• Keep your blood pressure as normal (120/80) as possible. As it reduces the risk of cardiovascular diseases in diabetes patients.

• Keep taking the drug even if you think your blood sugar levels are under control. If you miss a dose, do not take a larger dose. Consult your treating physician for advice. 
• Take short, frequent meals, and avoid prolonged fasting when taking this drug. Beware of symptoms of hypoglycaemia which include sweating, dizziness, palpitations, shivering, intense thirst, dry mouth, dry skin, frequent urination etc. Whenever you experience the symptoms mentioned above, immediately consume 5-6 candies, three glucose biscuits, or three teaspoons of honey/sugar and get in touch with your physician. Make sure to carry these with you at all times, especially for long travels. 
• Before the doctor prescribes this medicine, it is always better that your physician knows about any underlying conditions like kidney or liver disease, prior heart attack, alcohol intake, etc.
• Avoid drinking alcohol while on this drug as it increases the risk of hypoglycaemia (decrease in blood sugar which might be fatal in some cases) and lactic acidosis (when the lactic acid increases in the body, which impacts the functioning of various organs in the body).
• Try to quit smoking and reduce your intake of carbohydrate-rich food like potatoes, rice, mangoes, bread, sugar etc.