Old-line diabetes drugs finally revealed to be dangerous

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An estimated 26 million Americans suffer from type-2 diabetes, with about 1 million new cases diagnosed each year. This serious disease can lead to numerous adverse health effects, including cardiovascular disease, visual impairment, nerve damage, and kidney failure. That s why people with diabetes must be conscientious about taking their medications. However, a recent study has found that a certain class of long-used and widely prescribed diabetes drugs sulfonylureas is associated with a higher mortality risk.

Led by researchers from Summa Western Reserve Hospital in Ohio, the latest retrospective study analyzed the medical records of nearly 24,000 diabetes patients who were treated with one type of sulfonylurea (glyburide, glipizide, or glimepiride). Their outcomes were compared to those on metformin, another common diabetes drug that operates via a completely different mechanism.

After a median of 2.2 years of follow-up, researchers found that diabetics taking sulfonylureas had, on average, a 50 percent higher mortality risk than those who were treated with metformin. Among a subset of nearly 3,000 patients with a history of coronary artery disease, glyburide was associated with a 38 percent increased mortality risk, while that risk was 41 percent higher among those taking glipizide, compared to metformin.

Metformin, when not contraindicated, should be the first-line agent prescribed to control blood sugar levels in patients with type 2 diabetes, concluded lead study author Dr. Kevin Pantalone. But if sulfonylureas are required to control blood sugar levels, then glimepiride may be the preferred sulfonylurea in those with known coronary artery disease, he added.

The findings interested ACSH s Dr. Josh Bloom, who was quite surprised by the magnitude of the increased mortality risk. The first members of the sulfonylurea class of drugs were introduced in the 1960s, he says. That s why it s quite startling to see only now such a profound elevated risk for this well-known and often-used class of drugs.