Diabetes Drugs May Increase Risks

Type 2 diabetes patients taking certain sulfonylureas may face greater death risk

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Just as diabetes is a complex disease, treating diabetes also can be complicated. Some patients need only diet and exercise, while others need medications.

Some of these medications, however, may be harmful.

Type 2 diabetics taking any of three common diabetes drugs (glipizide, glyburide, and glimepiride) may have an increased risk of death, compared to patients taking the metformin - the oldest diabetes drug.

"Ask your doctor about the risks of diabetes medications."

Glipizide (sold as Glucotrol), glyburide (sold as Diabeta, Glycron, and others), and glimepiride (sold as Amaryl) are part of a class of drugs called sulfonylureas. For some time, all sulfonylureas were thought to be similarly effective and safe.

However, recent research led by Kevin M. Pantalone, DO, of Summa Western Reserve Hospital in Ohio, and colleagues, that compared the safety of those three drugs to that of metformin suggested otherwise.

They found that patients on any of the three sulfonylureas were 50 percent more likely to die than patients on metformin.

"We have clearly demonstrated that metformin is associated with a substantial reduction in [death] risk, and, thus, should be the preferred first-line agent, if one has a choice between metformin and a sulfonylurea," says Dr. Pantalone.

Among patients with heart disease, glipizide increased the risk of death by 41 percent, while glyburide increased that risk by 38 percent.

Glimepiride did not increase diabetics risk of death compared to metformin.

"Since many patients with type 2 diabetes also have [heart disease], our results could potentially impact the care of a large number of patients," says Dr. Pantalone.

"In these patients, we know that glimepiride appears to be safer than the other commonly prescribed sulfonylureas, glipizide and glyburide, available in the United States," he says.

Although this study suggests that the three sulfonylureas are associated with a high risk of death, it is important to remember that diabetes patients are most likely to die if their disease is not under control.

If you have diabetes, talk to your doctor before stopping any medications.

According to Dr. Pantalone, the results of this study can serve as a reminder that any medication can cause negative side effects.

"All drugs have risks, even those which are generic and relatively inexpensive," says Dr. Pantalone.

"It is important to talk to your doctor about which drugs may be better and safer options, which may vary depending on your other health conditions," he says.

The study - which involved nearly 24,000 type 2 diabetes patients who had previously taken one of the four drugs - was presented at the 94th Annual Meeting of the Endocrine Society. As such, it has yet to be reviewed by a scientific journal.

Reviewed by: 
Review Date: 
June 26, 2012
Last Updated:
November 29, 2012