Skip to content

    Diabetes Health Center

    Font Size

    Popular Diabetes Drugs Tied to Heart Failure

    Study Shows Sulfonylureas Have Higher Heart Failure Risk Than Metformin
    WebMD Health News
    Reviewed by Louise Chang, MD

    Dec. 4, 2009 -- Concerns that the diabetes drugs Avandia and Actos raise the risk for heart failure led the FDA to require label changes warning of the potential risk two years ago.

    Now a new study suggests this concern might be unfounded, but it also raises questions about a different class of oral diabetes drugs that have been used since the 1950s: sulfonylureas.

    Researchers reported that diabetes patients who used sulfonylureas had a higher risk of death from all causes and a higher risk of heart failure than diabetes patients who used the most widely prescribed diabetes drug, metformin.

    Compared with metformin, also known as Glucophage, single-drug treatment with first- and second-generation sulfonylureas was associated with up to a 61% increased risk for death. Users of second-generation sulfonylureas had up to a 30% higher risk for congestive heart failure.

    Patients treated with Actos or Avandia did not appear to have a greater risk for heart attacks than those treated with metformin.

    Treating Diabetes

    As many as 180 million people worldwide have type 2 diabetes, and heart attacks and heart failure are among the major killers associated with the disease.

    Over the past two decades, a host of drugs have been approved to treat diabetes. The drugs improve blood sugar control, but there have also been concerns that some may raise the risk of cardiovascular events in people who are already at high risk.

    In an effort to explore the issue, researchers in the U.K. examined the treatment records of more than 91,000 diabetes patients enrolled in a national database between 1990 and 2005.

    During the follow-up, almost 36,000 patients had heart attacks, 6,900 developed congestive heart failure, and just over 18,500 died.

    Metformin was the most widely prescribed drug, followed by second-generation sulfonylureas. Many patients took more than one diabetes drug.

    Among the major findings:

    • Compared with metformin, single-drug treatments with first- or second-generation sulfonylureas was associated with a 24% to 61% increased risk for death from all causes.
    • Compared to metformin, second-generation sulfonylurea use was associated with an 18% to 30% increased risk for heart failure.
    • Compared to metformin, treatment with Actos was associated with a 31% to 39% decreased risk for death.

    Today on WebMD

    Diabetic tools
    Symptoms, diagnosis, treatment, and more.
    woman flexing muscles
    10 strength training exercises.
    Blood sugar test
    12 practical tips.
    Tom Hanks
    Stars living with type 1 or type 2.
    kenneth fujioka, md
    Can Vinegar Treat Diabetes
    Middle aged person
    jennie brand miller

    Prediabetes How to Prevent Type 2 Diabetes
    type 2 diabetes
    food fitness planner