There is no difference between using a long or short-acting form of sulphonyulurea in terms of cardiovascular risks, researchers have said.
A Canadian team wanted to further investigate how different types of sulphonylurea drugs, which are used to control blood sugar levels in people with type 2 diabetes, can affect the risk of stroke, coronary heart disease, angina or a heart attack.
Some forms of sulfonylurea are short-acting, such as gliclazide, glipizide, and tolbutamide, while long-acting sulfonylureas include glyburide and glimepiride. The class of medication works by stimulating increased insulin production in the pancreas.
Researchers from the Centre for Clinical Endocrinology at the Lady Davis Institute in the Jewish General Hospital in Montreal knew that the treatment is linked with an increased risk of cardiovascular problems, but they wanted to assess whether the different types of the drugs made any difference.
Dr Samy Suissa, who led the research, said: “Our population-based cohort study showed no difference in the risk of major cardiovascular adverse events, cardiovascular death and all-cause mortality between pancreas-nonspecific and pancreas-specific sulfonylureas, thereby contradicting previous studies and arguing that the clinical implications of the lack of pancreas specificity of certain sulphonylureas may have been overstated.”
However, they did find that the risk of severe hypoglycemia was greater in those taking long-acting sulphonylureas.
The trial involved studying data, captured from the UK Clinical Practice Research Datalink between 1998 to 2013 of adults aged about 68, who all had type 2 diabetes. The researchers compared differences between long and short-acting sulphonylureas during a follow-up more than a year later.
The researchers concluded: “Finally, it corroborates the previously reported increased risk of severe hypoglycemia associated with long-acting sulphonylureas as compared with short-acting compounds.”
Other known disadvantages of sulphonylureas are that they encourage weight gain, continued problems with insulin resistance and may increase the risk of impaired long-term insulin production.
The findings of the study have been published in the Diabetes Care journal.

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