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Old Diabetes Drug Has Advantages

Report: Metformin Effective With Fewer Side Effects Than Newer Drugs

Diabetes Drugs and the Heart continued...

The AHRQ report came to the same conclusion.

The researchers wrote that other than an established increase in heart failure risk for the TDZs, the data are insufficient to show that Avandia users are more likely than users of other diabetes drugs to have heart attacks.

They call for high-quality studies to give doctors and patients a better idea of the risks and benefits associated with all oral diabetes drugs, either taken alone or in combination.

A spokesperson for Actos manufacturer Takeda Pharmaceuticals declined to comment on the report.

A spokeswoman for GlaxoSmithKline tells WebMD that there is "absolutely no new data" in the review. She says reviewers failed to include critical studies in their report, including the company's own ongoing investigation of the long-term impact of Avandia on the heart.

Interim results from that trial, "add to the weight of evidence, from both previously published long-term clinical trials and other studies, that the overall [cardiovascular] safety profile of Avandia is comparable to traditional antidiabetes treatments," she says.

Metformin Used First

Jean Slutsky, MSPH, of the AHRQ tells WebMD that the new report adds weight to a 2005 recommendation from the American Diabetes Association and the International Diabetes Federation identifying metformin as the initial treatment for newly diagnosed, non-insulin dependent diabetes.

"Metformin does offer some advantages over some of the other drugs prescribed for type 2 diabetes," she says. "But not all patients are alike, and some drugs may be tolerated better by certain patients."

American Diabetes Association president Larry C. Deeb, MD, agrees the new report should make doctors take a new look at some of the older diabetes drugs.

He adds that none of the oral diabetes drugs is particularly effective for treating severe insulin resistance and doctors often wait too long to put patients on insulin.

"It is not fair to patients with very out of control glucose levels to expect their blood sugar to return to normal with oral treatments, but that is happening all the time," he tells WebMD. "Doctors are afraid of insulin, and as a result many patients are living with out of control diabetes."

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