Sulfonylureas Up Cardio Events Versus Metformin

Sulfonylureas for initial treatment of diabetes linked to increase in composite of MI, stroke, death

TUESDAY, Nov. 6 (HealthDay News) -- Use of sulfonylureas for initial treatment of diabetes is associated with increased cardiovascular events and death compared with metformin, according to a study published in the Nov. 6 issue of the Annals of Internal Medicine.

Christianne L. Roumie, M.D., M.P.H., from the Veterans Affairs Tennessee Valley Healthcare System in Nashville, and colleagues conducted a retrospective cohort study to compare outcomes for 253,690 veterans who initiated metformin (155,025) or sulfonylurea (98,665) therapy for diabetes. The composite outcome consisted of hospitalization for acute myocardial infarction or stroke, or death, adjusting for baseline demographic and medical characteristics.

The researchers found that crude rates for the composite outcome were 18.2 per 1,000 person-years in sulfonylurea users and 10.4 per 1,000 person-years in metformin users (adjusted incidence rate difference, 2.2 more cardiovascular events with sulfonylureas per 1,000 person-years; adjusted hazard ratio [aHR], 1.21). For both glyburide (aHR, 1.26) and glipizide (aHR, 1.15) results were consistent in subgroup analyses and in propensity score-matched cohort and sensitivity analyses.

"These observations support the use of metformin for first-line diabetes therapy and strengthen the evidence about the cardiovascular advantages of metformin compared with sulfonylureas," the authors write.

Abstract
Full Text
Editorial

Copyright © 2012 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Blunt Chest Trauma
Journal of Trauma Nursing, November/December 2014
Expires: 12/31/2016 CE:2 $21.95


The School Age Child with Congenital Heart Disease
MCN, The American Journal of Maternal/Child Nursing, January/February 2015
Expires: 2/28/2017 CE:2.5 $24.95


Understanding multiple myeloma
Nursing Made Incredibly Easy!, January/February 2015
Expires: 2/28/2017 CE:2 $21.95


More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles

Comprehensive Care: Looking Beyond the Presenting Problem
Journal of Christian Nursing, January/March 2015
Free access will expire on March 2, 2015.


Pain and Alzheimer dementia: A largely unrecognized problem
Nursing Made Incredibly Easy!, January/February 2015
Free access will expire on February 16, 2015.


Glycemic control in hospitalized patients
Nursing2015 Critical Care, January 2015
Free access will expire on February 16, 2015.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events