We actually stopped Actos and I think that made a huge difference also. (When combined with insulin, there appears to be a large increase in CHF (although person had no edema, PND or other signs), just shortness of breath with any exertion.) We are normalizing the Vit D and I think that has made the h-u-g-e-s-t difference (besides possibly the Actos -- no echo so do not know?).