Heart disease risk linked to two common type 2 diabetes drugs

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Two drugs regularly prescribed for treating type 2 diabetes are linked with a heightened risk of heart attack, stroke, heart failure, or amputation, according to a new study from Northwestern University.

These drugs, sulfonylureas and basal insulin are often used when metformin, the standard initial treatment for type 2 diabetes, is insufficient or ill-tolerated.

Study Design and Findings

This research is the first to compare how each of the six major second-line drugs impacts heart outcomes in patients with type 2 diabetes taking a second medication.

The study analyzed data from 132,737 patients with Type 2 diabetes starting second-line treatment.

Surprisingly, one of these two drugs is prescribed to over half of the patients (60%) nationwide requiring a second-line drug.

However, the study found that patients taking one of these two drugs were significantly more likely to experience cardiovascular harm compared to those taking a newer class of diabetes drugs known as DPP-4 inhibitors.

The risk increased by 36% for sulfonylureas users and doubled for basal insulin users.

Staggering Implications

According to the study’s findings, doctors only have to prescribe basal insulin to 37 people over two years to observe one cardiovascular event, such as a heart attack, stroke, heart failure, or amputation.

For sulfonylureas, that number is slightly higher—103 people. Considering that these numbers are applied to the 30 million Americans with diabetes, the implications of potential harm to many patients are staggering.

A Call for a Paradigm Shift

The research team recommends that physicians consider prescribing newer classes of antidiabetic medications more regularly after metformin, such as GLP-1 agonists (e.g., liraglutide), SGLT-2 inhibitors (e.g., empagliflozin), or DPP-4 inhibitors (e.g., sitagliptin), instead of sulfonylureas or basal insulin.

However, these drugs are more expensive than sulfonylureas, which is the primary reason they are not as commonly prescribed.

Patients should be aware that the medications they’re taking to treat their diabetes could potentially lead to severe cardiovascular harm.

This study emphasizes the need for a paradigm shift in the treatment of Type 2 diabetes.

The study was observational, utilizing real-world evidence that complements findings from previous randomized trials, which studied only one active drug compared to a placebo.

The research, conducted by Matthew O’Brien and his team, is published in JAMA Network Open.

If you care about diabetes, please read studies that pomace olive oil could help lower blood cholesterol, and honey could help control blood sugar.

For more information about health, please see recent studies that blueberries strongly benefit people with metabolic syndrome, and results showing widely used diabetes drug metformin may reduce cognitive decline.

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