A recent study from Northwestern University has raised significant concerns about two commonly prescribed diabetes drugs—sulfonylureas and basal insulin—especially in relation to heart health.
These drugs are often used when metformin, the first-line treatment for type 2 diabetes, either isn’t effective on its own or cannot be tolerated by the patient.
However, the new research indicates that these medications may come with a higher risk of serious cardiovascular events, including heart attacks, strokes, heart failure, and even amputations.
The study, which was published in JAMA Network Open, involved data from 132,737 patients with type 2 diabetes who were beginning their second-line treatment after metformin.
The researchers compared the impact of six major second-line diabetes drugs on cardiovascular outcomes. Their findings were particularly concerning for sulfonylureas and basal insulin, two drugs that are widely used across the United States.
Basal insulin is a type of insulin that is designed to release slowly over the course of the day, helping to maintain steady blood sugar levels. Sulfonylureas, on the other hand, work by stimulating the pancreas to produce more insulin.
Both drugs have been staples in diabetes treatment, but this study suggests that they may come with significant risks.
According to the study, patients who were prescribed sulfonylureas had a 36% higher risk of experiencing serious heart-related issues compared to those taking DPP-4 inhibitors, a newer class of diabetes medication.
The risk was even more pronounced for patients on basal insulin, who were found to be twice as likely to suffer from cardiovascular problems.
Given these findings, the researchers suggest that physicians should consider prescribing newer classes of diabetes medications after metformin, such as GLP-1 agonists (e.g., liraglutide), SGLT-2 inhibitors (e.g., empagliflozin), or DPP-4 inhibitors (e.g., sitagliptin).
These newer drugs have been shown to have more favorable cardiovascular profiles, meaning they are less likely to cause heart problems.
However, there’s a significant catch: these newer drugs are generally more expensive than sulfonylureas and basal insulin. This cost difference is a major reason why sulfonylureas and basal insulin remain so commonly prescribed despite the risks.
The study’s authors argue that the potential heart risks should prompt healthcare providers to rethink their approach to prescribing second-line diabetes treatments.
By considering the long-term heart health of their patients, doctors might choose to recommend these newer, albeit pricier, medications more often.
This study highlights the importance of personalized medicine in the treatment of chronic conditions like type 2 diabetes.
While sulfonylureas and basal insulin have been effective in controlling blood sugar, their potential to harm heart health suggests that a one-size-fits-all approach may not be appropriate.
Instead, the choice of diabetes medication should be made with careful consideration of each patient’s overall health, including their cardiovascular risk.
In summary, while sulfonylureas and basal insulin are commonly used second-line treatments for type 2 diabetes, this study from Northwestern University shows that they carry significant risks for heart health.
Patients and healthcare providers should weigh these risks against the benefits and consider newer, safer alternatives whenever possible.
As the medical community continues to learn more about the impact of different diabetes medications on heart health, the goal should be to provide treatments that not only control blood sugar but also protect the heart.
If you care about diabetes, please read studies that not all whole grain foods could benefit people with type 2 diabetes, and green tea could help reduce death risk in type 2 diabetes.
For more information about health, please see recent studies about unhealthy plant-based diets linked to metabolic syndrome, and results showing Mediterranean diet could help reduce the diabetes risk by one third.
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