Scientists from Northwestern University have discovered that two commonly used medications for Type 2 diabetes may increase the risk of serious heart-related problems.
These drugs—sulfonylureas and basal insulin—are often prescribed when the standard first treatment, metformin, isn’t effective or can’t be tolerated by the patient.
However, new research shows they carry a significantly higher risk of events such as heart attacks, strokes, heart failure, or even amputations.
The study, led by Dr. Matthew O’Brien and his team, was published in JAMA Network Open. It is the first large-scale analysis to compare the effects of six major “second-line” diabetes medications on heart health.
Second-line medications are used when metformin alone isn’t enough to manage blood sugar levels. The findings have major implications, as one of these two drugs is given to 60% of patients who require additional treatment for diabetes.
The researchers analyzed data from 132,737 patients with Type 2 diabetes who were starting second-line treatments. They found that patients taking sulfonylureas had a 36% higher chance of experiencing cardiovascular issues compared to those using a newer drug class called DPP-4 inhibitors.
For patients on basal insulin, the risk was even greater—they were more than twice as likely to face cardiovascular complications.
To put this into perspective, the team explained that for every 37 patients prescribed basal insulin over two years, one person experienced a major heart problem, such as a heart attack or stroke.
For sulfonylureas, the number was slightly better, with one cardiovascular event occurring for every 103 patients. While these numbers may seem small, they become alarming when applied to the 30 million Americans living with diabetes.
The study also highlights the availability of safer alternatives. Newer classes of diabetes drugs, such as GLP-1 agonists (e.g., liraglutide), SGLT-2 inhibitors (e.g., empagliflozin), and DPP-4 inhibitors (e.g., sitagliptin), have shown better outcomes for heart health.
These medications are increasingly recommended for patients whose diabetes is not controlled by metformin alone.
Despite their benefits, these newer drugs are less frequently prescribed due to their higher cost. Sulfonylureas remain popular because they are more affordable, but this choice might come at the expense of long-term cardiovascular health.
The researchers emphasized the need for doctors and patients to be aware of these risks. Many people may not realize that the medications they take to control their blood sugar could lead to serious heart problems.
This study calls for a shift in how Type 2 diabetes is treated, urging healthcare providers to consider newer, safer drugs as the next step after metformin.
By using real-world data, the study provides a clearer picture of the risks associated with older medications.
These findings complement earlier clinical trials, which mainly tested individual drugs against placebos, offering a broader understanding of how different treatments compare in everyday settings.
For people living with Type 2 diabetes, the message is clear: managing blood sugar is important, but so is choosing medications that protect heart health. Physicians are encouraged to weigh these risks carefully and discuss them with their patients.
While the cost of newer drugs remains a challenge, their benefits could outweigh the financial burden in the long run, potentially saving lives and improving the quality of life for millions of individuals with diabetes.
If you care about heart health, please read studies that yogurt may help lower the death risks in heart disease, and coconut sugar could help reduce artery stiffness.
For more information about health, please see recent studies that Vitamin D deficiency can increase heart disease risk, and results showing vitamin B6 linked to lower death risk in heart disease.
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