In a nutshell
This study compared the risks associated with treatment with a sulphonylurea or metformin (Glucophage) in patients with type 2 diabetes.
Some background
Type 2 diabetes is a chronic, progressive disease that occurs due to increased resistance to insulin. It can be treated with several drugs. The first-line drug, which is most frequently used and is the best treatment available, is metformin (an oral drug that suppresses glucose production by the liver). In cases where metformin is inadequate or not suitable, a sulphonylurea (Glimepiride, Glipizide) may be added to the drug regimen or used alone instead of metformin. Sulphonylureas increase the amount of insulin produced by the pancreas.
Methods & findings
The study looked at a total of 76,811 patients who received metformin (average follow-up 2.9 years), and 15,687 patients who received sulphonylureas (average follow-up 3.1 years). The study evaluated the number of deaths that occurred in these patients and whether stroke or heart attack occurred.
Treatment with a sulphonylurea was associated with a 58% increased risk of all-cause mortality (death from any cause, not specifically from the drug). When patients were matched according to age, gender, body mass index (BMI), blood sugar levels, blood pressure and previous cancer, it was found that sulphonylureas continued to have an increased risk of all-cause mortality compared to metformin. The risk of stroke or heart attack, however, had a less clear association but was estimated to have an equal risk across both metformin and sulphonylureas.
The bottom line
Treatment with sulphonylurea as a first-line drug can be associated with higher risks of all-cause mortality compared to metformin.
What’s next?
Consult with your doctor on the benefits and risks associated with sulphonylurea treatment.
Published By :
Diabetes, Obesity and Metabolism
Date :
Apr 11, 2014
