In this careful study, some 5800 patients treated with pills for their diabetes were monitored for an average of about 5 years. Patients who were prescribed a sulfonylurea drug (chlorpropamide, tolbutamide or glyburide) experienced higher mortality rates than those who received metformin. Mortality from all causes and deaths attributable to heart attacks were both higher among patients taking sulfonylureas. Patients taking higher doses and those with better prescription compliance were more likely to die than those prescribed lower doses or who took less of their medication.
A colour graphic (3 forest charts of hazard ratios) is available.
Professor David Bell of the University of Alabama comments on the study, pointing out that the mechanism of action of sulfonylurea drugs can affect heart muscle and by this pathway may be responsible for the excess deaths. He recommends that sulfonylureas, still a popular first choice for treating diabetes mellitus, be used only as a third choice when considering oral treatment agents.
p. 169 Dose-response relation between sulfonylurea drugs and mortality in type 2 diabetes mellitus: a population-based cohort study
-- J. Johnson et al
p. 185 Do sulfynurea drugs increase the risk of cardiac events?