For many years, doctors have commonly prescribed two drugs—sulfonylureas and basal insulin—as backup treatments for people with type 2 diabetes when the first-choice drug, metformin, doesn’t work well.
But a new study from Northwestern University is raising serious concerns about the safety of these backup options.
The study looked at how six major second-line diabetes medications affect heart health. And the results were troubling. People who took sulfonylureas had a 36% higher chance of having heart problems like heart attacks or strokes. Those on basal insulin faced twice the risk compared to people who took newer drugs called DPP-4 inhibitors.
To understand what this means: if 37 people take basal insulin for two years, one of them is likely to suffer a major heart event. For sulfonylureas, it’s one out of every 103 people. With over 30 million people in the U.S. living with diabetes, this creates a serious risk for a huge number of patients.
These findings suggest that doctors and healthcare systems need to think again about which drugs they recommend. The newer medications—like GLP-1 agonists, SGLT-2 inhibitors, and DPP-4 inhibitors—appear to be safer for the heart. But they also cost a lot more, which is one reason why they are not used as often.
This study is a wake-up call. Even though it was an observational study that looked at data from over 132,000 people starting their second round of diabetes treatment, the risks it revealed can’t be ignored. It points to the need for major changes in how we treat type 2 diabetes—especially when it comes to protecting heart health.
Doctors should use this new information when choosing what medicines to give their patients. But there’s also a bigger issue: the high cost of newer, safer drugs.
Policymakers and insurance companies need to find ways to make these better options affordable so that patients don’t have to pick between good blood sugar control and keeping their hearts healthy.
This research was led by Matthew O’Brien and published in the medical journal JAMA Network Open. It’s a strong message to both doctors and patients: safety must come first. We can do better, and it’s time to make a change.
If you care about diabetes, please read studies about the cooking connection between potatoes and diabetes, and low calorie diets may help reverse type 2 diabetes.
For more health information, please see recent studies about protein power: a new ally in diabetes management, and pineapple and diabetes: A sweet surprise.
Copyright © 2025 Knowridge Science Report. All rights reserved.
