The present study compared the effects of therapy with either Metformin or Sulfonylureas (Glyburide, Glipizide) on cardiovascular events (heart attack and stroke) or death in patients with type 2 diabetes mellitus (DM2). The main findings were that treatment with Sulfonylurea was associated with an increased risk of cardiovascular disease (CVD) or death compared to Metformin.

Metformin and Sulfonylurea are blood glucose lowering drugs that are FDA approved for the treatment of DM2. Patients with Diabetes are more likely to die of CVD. The effects of Metformin and Sulfonylurea on CVD events are not well defined.

This study compares the risks of CVD events or death in patients with DMs treated with either drug. From the 253,690 patients with DM2 included, 98,665 were treated with Sulfonylurea and 155,025 received Metformin.

The risk for CVD events (heart attack and stroke) or death was 21% higher among Sulfonylurea users than Metformin. However, it is not clear from this study if the difference in risks is due to harm from Sulfonylureas, benefit from Metformin or both. Also, the patients included were mostly white males. Therefore it has to be tested on another study group that represents the general population, including females and other ethnicities.

In conclusion, the study suggests a higher risk of cardiovascular events or death in patients treated with Sulfonylurea compared with Metformin therapy. These findings support the use of Metformin as first-line treatment for DM2 and sustain the cardiovascular advantages of Metformin over Sulfonylurea.