For Type 2 diabetics, the bad news gets worse

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Last November we commented on a rather startling development in the treatment of type 2 diabetes. A widely-used family of drugs called sulfonylureas (Avandia and Glipizide, for 2 examples) was found to increase heart attacks, strokes and death by about 20 percent, when compared to patients who took metformin (another widely-used diabetes drug) alone.

If you haven t thrown your pills away yet, this may be a good time to ask your doctor about switching diabetes medication!

A new study presented at this year s annual meeting of the European Association for the Study of Diabetes in Barcelona, Spain, once again shows that patients taking sulfonylureas as first line treatment for type 2 diabetes had a higher mortality rate than those receiving metformin alone.

But this time, the all-cause death rate for sulfonylurea patients was quite a bit worse.

Specifically, the outcomes of over 76,000 patients who were prescribed metformin monotherapy were compared to more than 15,000 sulfonylureas users. The all-cause death rate for patients taking sulfonylureas was 58 percent(!) higher than for those taking metformin alone.

Lead author, Professor Craig Currie of Cardiff University in the UK concluded: Mortality was significantly increased in patients prescribed sulfonylureas as first-line, glucose lowering monotherapy, compared with metformin monotherapy. Whilst residual confounding and confounding by indication may remain, this study indicates that treatment with first-line monotherapy with sulfonylureas should be reconsidered.

Dr. Bloom says, This kind of thing happens from time to time. Fortunately, it is rare, but no drug is without risk, and occasionally one slips through. It can take years of post-marketing surveillance and tens of thousands of users to see something that is not picked up during the approval process.