Which diabetic drug is safer for older patients with type 2 diabetes, linagliptin or glimepiride?

This study compared the safety of two medications, linagliptin (Trajenta) and glimepiride (Amaryl). It found that the medications had the same risk of heart attack, stroke, or heart-related death, while linagliptin was associated with a lower risk of hypoglycemia (dangerously low blood glucose level).

There are many different treatments available for type 2 diabetes (T2D). Safety is very important when choosing a medication, especially for older patients. Some diabetic medications can be associated with a risk of heart problems, weight gain, or hypoglycemia. It is not fully clear which medications are the safest.

This study involved 6,033 patients with poorly controlled T2D. Group 1 was treated with linagliptin while group 2 was treated with glimepiride. Participants were followed for an average of 6.3 years.

The two groups had the same risk of stroke, heart attack, or heart disease-related death. The two groups also showed similar improvements in blood glucose control. However, the risk of moderate-to-severe hypoglycemia was 82% lower in the linagliptin group. This risk was similar across all age groups. 

Patients on linagliptin also had an average weight 1.54 kg lower than the glimepiride group. The linagliptin group also experienced fewer falls and broken bones.

This study showed that linagliptin may cause less hypoglycemia, falls, and broken bones than glimepiride.  The authors suggest that this may be a safer choice for older patients who are at higher risk from these complications.

Some information about the frailty of older participants was not included in this study. More studies are needed to confirm that these findings apply to the average elderly diabetic person. This trial was funded by Boehringer Ingelheim, the manufacturer of linagliptin.