These medications are commonly prescribed to patients after they have taken metformin, a widely accepted initial Type 2 diabetes treatment. These patients needed the second-line medication because the metformin alone didn’t work.
After analyzing the results, they found that 60 percent of patients who need a second-line drug are prescribed either sulfonylureas and basal insulin. They also discovered those who take one of these two drugs are more likely to experience a cardiovascular event, compared to those taking a newer class of diabetes drugs.
In fact, those on sulfonylureas were 36 percent more likely to have a heart attack, heart failure or stroke, and those on basal insulin were twice as likely.
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“According to our findings, we only have to prescribe basal insulin to 37 people over two years to observe one cardiovascular event, such as a heart attack, stroke, heart failure or amputation,” co-author Matthew O’Brien said in a statement. “For sulfonylureas, that number was a bit higher: 103 people. But when you apply these numbers to 30 million Americans with diabetes, this has staggering implications for how we may be harming many patients.”
The authors suggest that doctors prescribe newer classes of diabetes medications, such as GLP-1 agonists, SGLT-2 inhibitors or DPP-4 inhibitors. Although these drugs are more expensive, the scientists believe they can help lower the risk of heart damage.
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“This should force providers to think about cardiovascular effects of these drugs early in the course of diabetes treatment,” O’Brien said, “and shift prescribing patterns to newer drugs that have more favorable cardiovascular profiles.”