Researchers from the Vanderbilt University Medical Center have conducted an observational study with regards to treatment combinations for diabetes. They found out that diabetics who took insulin in combination with metformin, a common first-line therapy drug for diabetes, have a 30 percent higher risk of stroke, heart attack and death compared to patients who took metformin with another anti-diabetic drug called sulfonylurea. The findings of the study are published online in the Journal of the American Medical Association.
Christianne Roumie, M.D., MPH, associate professor of Medicine and Pediatrics at the Vanderbilt University Medical Center and lead author of the study, compared medical records along with colleagues coming from two groups of Veterans Health Administration patients with diabetes. Among the group, 2,436 patients were taking metformin and insulin together while 12,180 were taking metformin along with types of sulfonylurea. Accounting for other factors such as age, gender, ethnicity, smoking statues and other physiologic variables, those who took metformin with insulin were 30 percent more likely to suffer, heart attack, stroke or death compared to those who took metformin with sulfonylurea.
According to Roumie, “A couple of small clinical trials have shown that using insulin earlier in a disease course helps preserve beta cells in your pancreas longer.” But she also said that “multiple large clinical trials have found either no benefit or potential harm from attempting very tight management of glucose. We wanted to look within a real-world practice at the drugs that patients use and evaluate the outcomes.”
Roumie further wrote on the report, “Although adding insulin seems a reasonable option for some patients who have very high glucose or who desire flexible and fast blood sugar control, the study findings suggest that for most patients who need a second diabetes drug, adding a sulfonylurea to metformin should be preferred to adding insulin.”
Roumie and her colleagues are planning further studies to find out about the underlying mechanism that might help explain the increased risk associated with combining metformin and insulin.
Source: Vanderbilt University Medical Center. (2014, June 11). Insulin’s risks as second-line medicine to treat type 2 diabetes. ScienceDaily. Retrieved June 17, 2014 from www.sciencedaily.com/releases/2014/06/140611102105.htm
Tags: diabetes drug, Diabetes News, diabetes treatment, heart attack risk, insulin use