A new study from Northwestern University has found that two widely prescribed type 2 diabetes medications—sulfonylureas and basal insulin—are linked to an increased risk of heart attack, stroke, heart failure, and even amputation.
These drugs are often given to patients when metformin, the standard first-line treatment for diabetes, is not enough or cannot be tolerated.
Study Findings
This study is the first to directly compare the effects of six major second-line diabetes drugs on heart health. Researchers analyzed data from 132,737 patients who started a second medication for type 2 diabetes. The findings revealed that:
- 60% of patients who needed a second-line drug were prescribed either sulfonylureas or basal insulin.
- Patients taking sulfonylureas had a 36% higher risk of cardiovascular complications compared to those taking a newer class of diabetes drugs called DPP-4 inhibitors.
- Patients taking basal insulin had double the risk of cardiovascular events.
The numbers are concerning: for every 37 patients prescribed basal insulin, one will experience a heart-related complication within two years. For sulfonylureas, the risk applies to 103 patients. Given that nearly 30 million Americans have diabetes, the number of affected individuals could be staggering.
A Need for Change in Diabetes Treatment
The study’s authors urge doctors to reconsider how they prescribe second-line diabetes drugs. Instead of sulfonylureas or basal insulin, they recommend using newer and safer medications, such as:
- GLP-1 receptor agonists (e.g., liraglutide)
- SGLT-2 inhibitors (e.g., empagliflozin)
- DPP-4 inhibitors (e.g., sitagliptin)
These medications have been shown to be safer for the heart and reduce the risk of cardiovascular disease. However, they are significantly more expensive, which is why sulfonylureas are still widely used.
What Patients Should Know
People with type 2 diabetes should be aware that some of the medications they take may increase their risk of heart complications. Patients are encouraged to talk to their doctors about alternative options that may be safer for long-term health.
This study highlights the need for a major shift in diabetes treatment to prioritize heart health and patient safety.
The research, led by Matthew O’Brien, was published in JAMA Network Open.
If you care about heart health, please read studies about how drinking milk affects risks of heart disease, and herbal supplements could harm your heart rhythm.
For more information about heart health, please see recent studies about how espresso coffee affects your cholesterol level, and results showing Vitamin K2 could help reduce heart disease risk.
Copyright © 2025 Knowridge Science Report. All rights reserved.
