Millions of people around the world live with type 2 diabetes, a condition where the body struggles to use insulin properly, leading to high blood sugar levels.
Doctors often start treatment with a medicine called metformin, which has been used for many years and is known to be safe and effective.
However, some people cannot take metformin due to side effects or other health reasons. In those cases, doctors usually turn to other drugs to help control blood sugar.
Two of the most common second-choice medicines are sulfonylureas and basal insulin. These drugs have been around for a long time and are cheaper than newer options. But a new study from Northwestern University has found that these two drugs may come with serious health risks.
Researchers looked at over 130,000 people with type 2 diabetes who needed a second drug after metformin. The scientists compared six different types of diabetes drugs to see how they affected the heart. What they discovered was alarming.
People who took sulfonylureas had a 36% higher chance of developing heart problems, including heart attacks, strokes, heart failure, or even needing a leg or foot amputated. The risks were even worse for those taking basal insulin.
Their chance of having serious heart-related issues was twice as high as those taking a newer type of drug called DPP-4 inhibitors.
This is very concerning because about 60% of patients who need a second diabetes drug are given sulfonylureas or basal insulin. In the United States alone, around 30 million people have diabetes. That means millions may be using medicines that could harm their heart and blood vessels without knowing it.
There are safer options available. Newer types of diabetes drugs, like GLP-1 agonists (such as liraglutide), SGLT-2 inhibitors (like empagliflozin), and DPP-4 inhibitors (like sitagliptin), have shown to be safer for the heart.
These medicines not only help control blood sugar, but they also lower the risk of heart attacks and strokes. The downside is that they are often more expensive than older drugs.
Doctors and patients often choose cheaper medicines because of cost, especially if the newer ones are not fully covered by health insurance. However, this study shows that choosing cheaper drugs could lead to serious health problems. Paying less now might lead to bigger health costs in the future.
The findings come from real-world data, not just clinical trials. This means the study looked at people in everyday life, not just carefully selected groups in a lab setting. This gives a clearer picture of how these drugs affect regular patients.
The researchers say it is time for doctors to rethink how they treat type 2 diabetes. Managing blood sugar is important, but keeping the heart safe is just as important. People with diabetes are already at a higher risk of heart disease, so the medicine they take should not make that risk worse.
This study, led by Dr. Matthew O’Brien and published in the journal JAMA Network Open, sends a strong message: doctors and patients need to talk about all the risks and benefits of diabetes drugs—not just how well they lower blood sugar. Choosing the right drug can make a big difference not only in blood sugar levels but also in long-term heart health.
If you care about heart disease, please read studies that herbal supplements could harm your heart rhythm, and how eating eggs can help reduce heart disease risk.
For more information about heart health, please see recent studies about A heart-healthy diet guide for seniors and results showing that Vegan diet may reverse heart disease naturally.
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