1. Home>
2. Medical News>
3. Physican's First Watch>

Oral Diabetes Drugs and CVD Risk

An assessment of "real world" use of oral agents for type 2 diabetes shows significant risk differences among drug classes, BMJ reports.

Using a U.K. general practice database, researchers retrospectively examined prescribed drugs and subsequent outcomes among some 90,000 patients, who were followed a mean of 7 years. The outcomes examined included incident myocardial infarction, heart failure, and all-cause mortality.

Using metformin monotherapy as the reference group, the researchers noted:

• First- and second-generation sulfonylureas carried significantly higher mortality risks; second-generation drugs were more likely to cause heart failure.
  
• In some models, the sulfonylureas were associated with higher MI risk.
  
• Contrary to previous findings, no excess MI risk with rosiglitazone was found.
  
• Pioglitazone was associated with lower mortality (and had a more favorable risk profile than rosiglitazone).
  

The authors write that the sulfonylureas' unfavorable risk profile "is consistent with the recommendations of the American Diabetes Association ... that favor metformin as the initial treatment for type 2 diabetes."

LINK(S):

BMJ article (Free)

American Diabetes Association guidelines (Free)

Published in Physician's First Watch December 4, 2009