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

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, there
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