Sulfonylureas May Increase Cardiovascular Events

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Sulfonylureas seem to be coming undermore scrutiny lately. This is apparently justified on several frontsbecause of changes that have alerted researchers of some very realproblems. Many of these problems were not part of the requirementsor perceived requirements when the drugs were originally approved bythe Food and Drug Administration.
Gretchen Becker wrote about this class of drugs causing pancreas fatigue and decline of the functionality ofthese drugs when used for extended periods. While I am a believer ofthis, this discussion is still controversial and more research isneeded to prove this beyond argument. I am one of the fortunatepeople because of my allergy so this is not something I need toconcern myself with in my lifetime. This was also the reason that Isuspect my doctor was so willing to move me to insulin when the oralmedications were not helping manage my blood glucose levels.
Recently, another concern has beenbrought to the front. The American Diabetes Association stated thatsulfonylurea drugs are insulin-production stimulants that have beenin use since the 1950s. Metformin, also dating to the 1950s, works bylowering blood glucose levels by reducing the quantity of glucoseentering the blood. A recent multi-year study published in the Nov.6 issue of the journal Annals of Internal Medicine found thatsulfonylurea use was associated with a 21 percent increased risk ofacute myocardial infarction, stroke, or death.
For comparison purposes to determinethe impact of the two drugs on cardiovascular results, a pool of morethan 250,000 veterans over the age of 18 was used. No average age ofthe study is given and none of the participants had any seriousmedical complications other than diabetes at the start. Almost100,000 were placed on a standard regimen of sulfonylurea therapy,while slightly over 155,000 took metformin.
The authors stated that theirobservations were consistent with previous indications that metforminis associated with fewer serious heart issues than sulfonylureas. Even with this, the researchers stated that the findings suggestmetformin should be the oral treatment of choice. They did stressmore testing is needed to determine if their findings would apply towomen or other racial and ethnic groups since 97 percent of theirstudy participants were men and 75 percent were white.
While the findings pointing to thissituation have probably been there for several decades the U.S. Foodand Drug Administration did not require testing for cardiovascularoutcomes when looking at diabetes drugs until very recently.
The drugs used for the study includefor metformin, the brand names of Glucophage and Fortamet (orGlucophage XR). The drugs used for sulfonylureas include glyburide(brand name - DiaBeta) and glipizide (brand name - Glucotrol). Noother sulfonylureas were mentioned, therefore, we cannot know if theothers are more or less likely to cause cardiovascular problems.