This blog tracks updates to the Blood Sugar 101 Web site.

Tuesday, December 9, 2008

Heart Attack Risk with Different Sulfonylurea Drugs Quantified

Page Changed: Diabetes Drugs: Quick Summary and The Truth About Oral Diabetes Drugs

Added reference to a new study which quantified the risk of cardiovascular disease with the different sulfonylurea drugs. The main finding was:
The hazard of developing CAD [coronary artery disease] associated with initial treatment increased by 2.4-fold ... with glibenclamide [glyburide]; 2-fold ... with glipizide; 2.9-fold ...with either, and was unchanged with metformin. The hazard decreased 0.3-fold ... with glimepiride, 0.4-fold ... with gliclazide, and 0.4-fold ... with either.

This would lead us to believe that that Amaryl (glimepiride) and Diamicron (gliclazide) (not available in the U.S.) are the only safe drugs in this family. The mechanism that explains that finding has to do with the fact that the older sulfonylurea drugs not only stimulate a receptor on the beta cell, but they stimulate one found in heart muscle. The newer sulf drugs are designed to be specific to the beta cell.

Here is the study:

Risk of coronary artery disease associated with initial sulphonylurea treatment of patients with type 2 diabetes: A matched case–control study Shaukat M. Sadikot et al. Diabetes Research and Clinical Practice.Volume 82, Issue 3, December 2008, Pages 391-395

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