Type 2 Diabetes

It's a Type 2 Life
It's a Type 2 Life

San Francisco Bay Area resident Patrick Totty writes about his experiences living with type 2 diabetes

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Do Sulfonylureas Add to Cardiovascular Risks?

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One of the challenges to having type 2 is trying to stay abreast of new research about the disease. That’s why routinely checking out sites like Healthline on the Internet can be a big help when it comes to talking to your doctor or endocrinologist.

For example, I just ran across a research report that says metformin users may enjoy a substantially lower risk of being hospitalized for cardiovascular problems (heart attack, stroke) than type 2s who take sulfonylureas.

The two are the most common “gateway” drugs doctors prescribe to newly diagnosed type 2s. Metformin (brand names Glucophage and Fortamet) works by controlling the liver’s production of glucose, while sulfonylureas (such as glyburide and glipizide) work by stimulating insulin production.

A several-year study of 250,000 military veterans with type 2 diabetes has concluded that people who take metformin are 21 percent less likely to be hospitalized or die from cardiovascular conditions than people on metformin.

(It’s important to note that the patients under study had no other health problems other than type 2 when they began taking either metformin or sulfonylureas.)

Researchers said the 21 percent difference is “clinically important,” but can’t really say why one drug seems to pose a lesser cardiovascular risk than the other.

Also, although the 250,000-member patient cohort was huge, it was also 75 percent white and 97 percent male. So it’s unknown what percentage differences might appear in a large sampling of women or other ethnicities.

This isn’t the first time I’ve run across this possible link between sulfonylureas and increase cardiovascular risks. However, the thing to remember is that we still don’t know why sulfonylureas are associated with heightened CV risks.

Because there’s a big difference between associated with something and being the cause of it, I’m discussing the sulfonylurea/CV link as a heads up, not a dire warning. Part of staying informed about our condition is understanding that there simply is no such thing as a fool-proof therapy that has no side effects. 

Still, as you discuss your diabetes medications with your healthcare provider, it’s useful to bring up any concerns you have about possible ill effects. It helps the relationships when your provider sees you taking the time to be informed and really understanding that you yourself are the ultimate manager of your diabetes treatment.

 

 

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About the Author

Bay Area resident Patrick Totty was diagnosed with type 2 diabetes in July, 2003.

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