Sulfonylureas may put users at increased mortality risk

Three commonly prescribed type 2 diabetes drugs have been linked with an increased of death in a new study conducted by researchers in Cleveland, Ohio.
The drugs, glipizide, glyburide, and glimepiride, are part of a group of medicines known as sulfonylureas, which help type 2 diabetes patients lower blood sugar levels by stimulating the production of insulin in the pancreas.
Sulfonylureas had been considered comparable in safety and effectiveness. However, several recent studies suggested this is not the case after finding that some of the drugs might be safer than others.
Investigating these findings further, researchers from the Summa Western Reserve Hospital and Cleveland Clinic compared the three products to another type 2 diabetes medication, metformin, using health records of 23,915 patients who were treated with one of the sulfonylureas and/or metformin over a period of eight years.
They found that the sulfonylureas had a more than 50 per cent greater mortality risk compared with metformin use, with the relative risk ranging from 59 per cent with glyburide to 68 per cent with glimepiride.
Kevin Pantalone, endocrinologist at Summa Western Reserve Hospital and lead author of the study, said: “We have clearly demonstrated that metformin is associated with a substantial reduction in mortality risk, and thus should be the preferred first-line agent, if one has a choice between metformin and a sulfonylurea.”
Pantalone and colleagues also revealed that among patients with coronary artery disease (CAD), both glipizide and glyburide were associated with a significantly increased risk of death, compared to metformin, but not glimepiride.
“Our results suggest that if a sulfonylurea is required to control blood sugar levels, glimepiride may be the preferred sulfonylurea in those with known coronary artery disease,” he added.