Two Type 2 diabetes drugs linked to higher risk of heart disease

https://www.eurekalert.org/pub_releases/2018-12/nu-tt2121818.php

Public Release: 21-Dec-2018
Northwestern University

Two drugs commonly prescribed to treat Type 2 diabetes carry a high risk of cardiovascular events such as heart attack, stroke, heart failure or amputation, according to a new Northwestern Medicine study.

•••••
The two drugs -- sulfonylureas and basal insulin -- are commonly prescribed to patients after they have taken metformin, a widely accepted initial Type 2 diabetes treatment, but need a second-line medication because metformin alone didn't work or wasn't tolerated.

•••••

"According to our findings, we only have to prescribe basal insulin to 37 people over two years to observe one cardiovascular event, such as a heart attack, stroke, heart failure or amputation," O'Brien said. "For sulfonylureas, that number was a bit higher -- 103 people. But when you apply these numbers to 30 million Americans with diabetes, this has staggering implications for how we may be harming many patients."

Physicians should consider prescribing newer classes of antidiabetic medications, such as GLP-1 agonists (e.g. liraglutide), SGLT-2 inhibitors (e.g. empagliflozin)or DPP-4 inhibitors (e.g. sitagliptin), more routinely after metformin, rather than sulfonylureas or basal insulin, the study authors suggest.

These drugs, however, are more expensive than the sulfonylureas, which is the main reason they are not as commonly prescribed, O'Brien said.

•••••