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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
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