Navigation Links
Diabetes Drugs Go Head-to-Head in Study
Date:12/3/2009

Metformin outperforms widely used sulfonylureas, but each patient will be different, experts say

THURSDAY, Dec. 3 (HealthDay News) -- A class of drugs still taken by millions of people with type 2 diabetes is associated with a higher risk of dying and heart failure than the newer treatment metformin, researchers say.

Sulfonylureas, long a mainstay of diabetes treatment, performed less well than metformin in a study of oral anti-diabetes drugs, but doctors said the findings aren't necessarily a reason to discontinue taking them. Glyburide, glipizide and glimepiride are examples of sulfonylureas.

Metformin, which is sold as Glucophage and other brand names, is already the first-choice therapy for type 2 diabetes, and the findings are in line with new American Diabetes Association recommendations, meaning the results won't change the way patients are already treated.

"This raises some interesting points for other, more specific research, but it won't affect the way we practice medicine tomorrow," said Dr. Robert Scott III, assistant professor of internal medicine at Texas A&M Health Science Center College of Medicine and senior staff cardiologist with Scott & White, Temple, Texas. "Certain diabetes medications may be a little bit more heart friendly than some of the older diabetes medications, but the bottom line is, we can't draw firm conclusions from this."

Other experts agree.

"Metformin is widely believed to exert a favorable cardiovascular effect, and these findings support this observation," added Dr. Steve Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, while pointing out that the study has "important limitations" and should not be considered "proof of differences between various drug therapies."

The new study, appearing in the Dec. 4 issue of BMJ, also found that the diabetes medications Actos (pioglitazone) and Avandia (rosiglitazone) did not seem to raise the risk of heart attack. But Actos was associated with a lower risk of dying than Avandia, indicating Actos might be the preferred choice.

Both drugs belong to the class of medications known as thiazolidinediones.

The hundreds of millions of people around the world who have type 2 diabetes have at least double the risk of dying, largely from cardiovascular disease, than otherwise healthy people.

Because elevated blood sugar can destroy blood vessels and organs of the body, drugs to control blood glucose levels are an important component of diabetes treatment. For years, though, researchers worried that these drugs might up the risk for heart problems in a population already at higher risk for such complications.

In this study, researchers from Imperial College London and other institutions looked at records from 1990 through 2005 for over 91,500 diabetics in the United Kingdom.

Compared to those taking metformin, people taking first- or second-generation sulphonylureas had a 24 to 61 percent higher risk of dying from all causes. Those taking second-generation sulphonylureas had up to a 30 percent increased risk for congestive heart failure.

Individuals taking Actos had a 31 to 39 percent lower risk of dying compared with people taking metformin.

Meanwhile, people taking Avandia (rosiglitazone) had a 34 to 41 percent higher risk of dying than people taking its cousin, Actos (pioglitazone).

"A large difference in outcome between pioglitazone and rosiglitazone has been observed in several other studies. Once again, these authors confirm that rosiglitazone appears to be associated with substantially worse cardiovascular outcomes compared with pioglitazone," Nissen said.

The element of choice is still an important one to consider, one expert pointed out.

"Sometimes diabetes patients can't tolerate certain medicines because of side effects, therefore they're left with taking older medicines that might be associated with an increase of heart attack or heart problems, but when you look at the relative risk of that versus the risk of having uncontrolled diabetes, taking that medicine might be more beneficial for certain patients," Scott said.

Although the study was not funded by pharmaceutical companies, several of the study authors do have ties to different drug companies, including GlaxoSmithKline, which makes Avandia, and Takeda Pharmaceuticals, which makes Actos.

More information

The American Diabetes Association has more on type 2 diabetes.



SOURCE: Steven E. Nissen, M.D., chairman, department of cardiovascular medicine, Cleveland Clinic; Robert Scott III, M.D., Ph.D., assistant professor of internal medicine, Texas A&M Health Science Center College of Medicine, and senior staff cardiologist, Scott & White, Temple, Texas; Dec. 4, 2009, British Medical Journal


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Interactive Traveling Diabetes Exhibit to Be Unveiled at Detroit Science Center
2. MyCareTeam™ Significantly Extends Diabetes Offering to Include Management of Hypertension, Obesity, and Congestive Heart Failure
3. Sugary Colas Tied to Gestational Diabetes
4. LeapFrog Invests $6M in AllLife, Innovative African HIV and Diabetes Insurer
5. Cardiovascular risk in youth with type 1 diabetes linked primarily to insulin resistance
6. Diabetes Cases Expected to Double in 25 Years
7. Diabetes Population to Double, Diabetes Costs to Nearly Triple, in 25 Years, New Study Shows
8. Diabetes cases to double and costs to triple by 2034
9. Type 1 Diabetes May Have a New Foe
10. One Step Closer to New Diabetes Treatment
11. Home Care Delivered, Inc. Recognizes November as National Diabetes Awareness Month
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... North Carolina (PRWEB) , ... June 26, 2016 , ... ... release of a new product that was developed to enhance the health of felines. ... for centuries. , The two main herbs in the PawPaws Cat Kidney Support ...
(Date:6/25/2016)... ... , ... The temporary closing of Bruton Memorial Library on June 21 due to a possible ... often overlooked aspect of head lice: the parasite’s ability to live away from a human ... but a necessary one in the event that lice have simply gotten out of control. ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, ... Bronze Wellness at Work award to iHire in recognition of their exemplary accomplishments in ... the 7th annual Maryland Workplace Health & Wellness Symposium at the BWI Marriott in ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, ... at his family verbally and physically. , “When something upset him, he couldn’t control his ... it. He would throw rocks at my other children and say he was going to ...
(Date:6/24/2016)... ... ... BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ‘Business for a ... an hour by 2020 and then adjusting it yearly to increase at the same rate ... assure the wage floor does not erode again, and make future increases more predictable. , ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 Research ... MEMS Devices Medical Market Analysis 2016 - Forecast to 2022" ... The report contains up to date financial data ... analysis. Assessment of major trends with potential impact on the ... analysis of market segmentation which comprises of sub markets, regional ...
(Date:6/23/2016)... -- Bracket , a leading clinical trial technology and ... platform, Bracket eCOA (SM) 6.0, at the 52 nd ... 2016 in Philadelphia , Pennsylvania.  A demonstration ... of its kind to fully integrate with RTSM, will be ... is a flexible platform for electronic clinical outcomes assessments that ...
(Date:6/23/2016)... 2016  Astellas today announced the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered in ... America . ... ... ... ...
Breaking Medicine Technology: