Sulfonylurea drugs and metformin are the two most commonly prescribed medications for treatment of type 2 diabetes.
However, a new study has found that people who use sulfonylureas are at greater risk of suffering heart disease and death than those taking metformin, supporting the use of metformin as the preferred starting drug therapy for type 2 diabetics .
The large study, published in the latest issue of the Annals of Internal Medicine, was carried out by Dr Christianne L. Roumie and colleagues from the Nashville Veterans Affairs Medical Center in Tennessee, USA.
To compare the impact of the two oral medications on cardiovascular health, the researchers analysed health data from over 250,000 veterans with type 2 diabetes who started sulfonylurea or metformin therapy between 2001 and 2008.
They found that for every 1,000 people who took sulfonylureas (glyburide and glipizide) for one year, there were two more cases of heart attack, stroke or death compared to those taking metformin.
As a result, metformin users had a “modest but clinically important” 21 per cent lower risk of being hospitalised due to cardiovascular complications
than patients on sulfonylureas.
“These observations support the use of metformin for first-line diabetes therapy and strengthen the evidence about the cardiovascular advantages of metformin compared with sulfonylureas,” the authors said.
However, they stressed that their findings may not apply to women or other ethnic groups as the vast majority of the study participants were white males.

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