, 1988Over the past decade, we have witnessed several controversial incidents of com-mon therapies causing uncommon adverse events. Here, we present one such contro -versy regarding rosiglitazone, a thiazo-lidinedione drug that was approved in the United States in 1999 on the basis of improvement in the surrogate outcome of glycemic control in patients with type 2 diabetes. Within a few years of approval, early storm clouds began to gather—it was suggested that the drug was associated with hemodilution, anemia, weight gain, edema, and increased risk of heart failure. This was followed by thunder rumbles arising from cardiovascular ischemic events in pre-diabetic and diabetic patients. Eventually, the lightning strike caused by Nissen and Wolski’s highly publicized meta-analysis