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

Tuesday, April 12, 2011

Huge Long-Term Study: Glibenclimide, Glipizide, Glimipiride, and Tolbutamide Associated with Increased Risk of Death and Heart Attack.

Page Changed Amaryl, Glyburide, Prandin, Starlix: Drugs that Stimulate Insulin Secretion

Added this text:

Then in 2011, a study analyzed the health records of "All Danish residents >20 years, initiating single-agent I[nsulin] S[ecretogogues, ie. Sulfs and glinides] or metformin between 1997 and 2006 were followed for up to 9 years (median 3.3 years)." It found the following drugs were as safe as Metformin: Prandin (repaglinide), and Diamicron (gliclazide, not sold in the U.S.).

All the other sulfonylurea drugs raised the risk of death, whether or not people had had a heart attack before taking them. The study concludes:
Monotherapy with the most used I[nsulin]S[ecretagogues]s, including glimepiride, glibenclamide, glipizide, and tolbutamide, seems to be associated with increased mortality and cardiovascular risk compared with metformin. Gliclazide and repaglinide appear to be associated with a lower risk than other I[nsulin]S[ecretagogues]s.
Mortality and cardiovascular risk associated with different insulin secretagogues compared with metformin in type 2 diabetes, with or without a previous myocardial infarction: a nationwide study. Tina Ken Schramm et al. Eur Heart J (2011) doi: 10.1093/eurheartj/ehr077

Friday, April 8, 2011

Statin effectiveness doess not correlate with CRP in people at very high risk of heart attack

Page changed: A1c and Post-Meal Blood Sugars Predict Heart Attack

Added the following reference to this new study to the discussion of the relationship of CRP and statin effectiveness.

A larger analysis published in 2011 in the Lancet seems to contradict this finding because it found statins prevented a significant number of cardiovascular events regardless of CRP level.

C-reactive protein concentration and the vascular benefits of statin therapy: an analysis of 20 536 patients in the Heart Protection Study. Heart Protection Study Collaborative Group. The Lancet Volume 377, Issue 9764, Pages 469 - 476, 5 February 2011 doi:10.1016/S0140-6736(10)62174-5

However, that is not quite what the study really showed, because all the participants in that study were at high risk of heart attack. The earlier study, in contrast, was a study of people who did not have a higher than normal risk of heart attack.

No one argues that statins don't help people who are at very high risk of heart attack--but it is a mistake to include people with diabetes who have been in excellent control for years and maintain A1cs below 6% in that group. The Lancet study treated people with a diabetes diagnosis as "high risk" but in the UK people with diabetes are considered to be in "excellent control" if they have A1cs approaching 8% and those wishing to achieve tighter control receive little support, no medication, and often no test strips.

Wednesday, April 6, 2011

Metformin reduces the invasiveness of endometrial cancer cells by 25%

Page Changed: Metformin.

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A study conducted in women with PCOS published in 2011 found that six months of treatment with metformin decreased the invasiveness of endometrial cancer cells by 25% compared to the activity of the same cells in women with PCOS who had not taken metformin. The design of this study makes it more likely that it is the drug itself, not correlated factors, that explain the anti-cancer effect of metformin.

Metformin Treatment Exerts Antiinvasive and Antimetastatic Effects in Human Endometrial Carcinoma Cells. Journal of Clinical Endocrinology & Metabolism , 2010; 96 (3): 808 DOI: 10.1210/jc.2010-1803