Skip to content

Diabetes Health Center

Font Size

Metformin: Safer for Heart Than Older Diabetes Drugs?

Study Suggests Diabetes Patients Taking Sulfonylureas Have Higher Risk of Heart Problems
WebMD Health News
Reviewed by Laura J. Martin, MD

June 28, 2011 (San Diego) -- Older people with type 2 diabetes who take an older class of oral diabetes drugs called sulfonylureas may have a higher risk of developing heart problems than those who take metformin.

In a two-year study of 8,502 people with type 2 diabetes aged 65 and older, 12.4% of those who started therapy with a sulfonylurea drug had a heart attack or other heart problem, compared with 10.4% of those who started with metformin.

Additionally, people taking sulfonylurea drugs experienced heart problems sooner after starting treatment than those taking metformin.

"The findings are important because older patients with diabetes are at particular risk for cardiovascular disease, and sulfonylureas continue to remain a commonly used medication in this population," says researcher Alex Z. Fu, PhD, an associate faculty member in the department of quantitative health sciences at the Cleveland Clinic.

Sulfonylurea drugs, which include chlorpropamide, glyburide, glipizide, tolazamide, and tolbutamide, are often one of the first medications prescribed to lower blood sugar levels in people with type 2 diabetes, he says.

The findings were presented here at the 71st Scientific Sessions of the American Diabetes Association.

Metformin vs. Sulfonylureas

Nearly 26 million Americans have diabetes; 95% of them have type 2 diabetes. It develops when the body does not produce enough insulin and/or the insulin that is produced isn't used properly.

As a result, insulin can't do its job regulating blood sugar. Persistently high blood sugar levels can lead to complications ranging from blindness to kidney failure. Heart attacks and heart failure are among the major killers associated with diabetes.

Over the past two decades, many 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, especially in people who are already at high risk.

In 2007, Avandia was tied to heart risks, and the FDA recently announced that after Nov. 18 doctors will have to enroll patients in a special registry in order to receive the drug.

Metformin, which has been on the market since 1995, is usually recommended as a first-line treatment for diabetes because it is relatively safe and cheap, says David M. Kendall, MD, chief scientific and medical officer for the American Diabetes Association.

Is This Normal? Get the Facts Fast!

Check Your Blood Sugar Level Now
What type of diabetes do you have?
Your gender:

Get the latest Diabetes newsletter delivered to your inbox!


Your level is currently

If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Did You Know Your Lifestyle Choices
Affect Your Blood Sugar?

Use the Blood Glucose Tracker to monitor
how well you manage your blood sugar over time.

Get Started

This tool is not intended for women who are pregnant.

Start Over

Step:  of 

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
Home Healthcare

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