Popular Diabetes Drugs Tied to Heart Failure
Study Shows Sulfonylureas Have Higher Heart Failure Risk Than Metformin
WebMD News Archive
Metformin as a First-Line Treatment
First-generation sulfonylureas in this study include the drugs acetohexamide
and tolazamide (Tolinase).
Second-generation versions from the study include glipizide (Glucotrol),
(Amaryl), and glyburide (Diabeta, Micronase, Glycron, Glynase).
Study researcher Ionna Tzoulaki, PhD, of the Imperial College London, tells
WebMD the findings are consistent with current recommendations by the American
Diabetes Association (ADA) and other diabetes groups designating metformin as
the first-line oral treatment for type 2 diabetes.
ADA president-elect for medicine and science Richard M. Bergenstal, MD,
"A decade ago it was something of a toss-up as to whether a new patient
would be given metformin or a sulfonylurea," he tells WebMD. "But metformin has
earned the right to be the first-line oral drug."
The bigger issue, he says, is whether aggressive glucose control is really
as important as has been widely believed in managing type 2 diabetes.
Bergenstal is executive director of the International Diabetes Center in
"Recent studies have failed to confirm that glucose control really benefits
the heart," he says. "And since 80% of diabetes deaths are heart related, it is
clear that controlling cardiovascular risk factors like
blood pressure and
cholesterol should be a major focus."
Bergenstal says that a sulfonylurea may still be a good option for
individual patients who can't take metformin or need additional medication.
Patients and their doctors have to weigh individual risks and benefits.
No one should stop taking their medications based on this study, Tzoulaki