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December 9th, 2009
Battle of the Type 2 Diabetes Treatments

A treatment for type 2 diabetes, used by millions of people, is connected with a higher risk of dying and heart failure compared to the newer treatment metformin, a new study suggests.

Sulfonylureas, a common diabetes treatment, was tested against metformin in a study of anti-diabetes drugs taken orally and did not perform as well. Examples of Slufonylureas are Glyburide, glipizide and glimepiride.

Metaformin, also known as Glucophage, is the first-choice prescription for type 2 diabetes patients already, meaning that the research findings are aligned with the American Diabetes Association’s new recommendations. This means that doctors will not change the way they treat patients.

“This raises some interesting points for other, more specific research, but it won’t affect the way we practice medicine tomorrow,” says 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.”

This new study also discovered that two other diabetes medications Actos and Avandia did not increase the risk of heart attack. However, Actos seemed to include a lower risk of dying rather than Avandia meaning that Actos may be the better choice as a prescription drug.

People dying from type 2 diabetes have trouble with cardiovascular disease. This is because high blood sugar can kill blood vessels and organs of the body, drugs that control the levels of blood glucose are therefore an important component of diabetes treatment.

In this study, records from 1990 through 2005 of 91,500 patients with type 2 diabetes in the United Kingdom were analyzed.

Patients taking sulphonylureas treatment had a 24-61% higher risk of dying than those taking metformin. Those taking Actos had a 31-39% lower risk of dying as opposed to people taking metformin.

In the meantime, patients taking Avandia had a 31-41% higher risk of dying compared to Actos.

The element of choice, however, remains to be the most important element to consider when choosing medication.

“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.


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