A Danish study of 107,806 adults taking various diabetes medications has found that three drugs are the most effective at lowering the risk of cardiovascular disease and death: metformin, gliclazide (not marketed in the US), and repaglinide (Prandin). Other common diabetes medications, including glimepiride, glibenclamide (glyburide), glipizide, and tolbutamide, were linked to a higher risk of death both from all causes and from heart attack and stroke.
Researchers looked at the patients in the study group who had never had a cardiovascular event (9,607 had experienced a previous heart attack or stroke) to see which drugs might be more closely associated with a higher risk of death from all causes. They found that people taking glimepiride ran a 32 percent higher risk, while those taking glipizide ran a 27 percent higher risk, and those taking glibenclamide ran a 19 percent higher risk. People taking tolbutamide versus metformin ran a 28 percent higher risk of death.
The researchers reported that the risks were even higher for people taking these drugs who had experienced previous cardiovascular events.
Previous research has shown that metformin reduces the risk of major cardiac events and death by about 40 percent compared to placebo. The Danish study showed that the risk profiles posed by gliclazide and repaglinide were about the same as metformin.
The drug classes of the above-named drugs include:
• Glibenclamide/Glyburide: sulfonylurea
• Gliclazide: sulfonylurea
• Glimepiride: sulfonylurea
• Glipizide: sulfonylurea
• Metformin: biguanide
• Replaginide: meglitinide (also “glinides”)
• Tolbutamide: sulfonylurea
The researchers cautioned people with diabetes to consult with their doctors if they are concerned about potential dangers from the drugs they’re taking. Unilaterally ceasing prescribed medications could be dangerous.
Results of the study were published online in the European Heart Journal.