Heart Safety and Type 2 Drugs

There’s long been a debate about the long-term cardiovascular safety of type 2 oral medications in the sulfonylurea class, but a study found the drugs are unlikely to harm the heart. A trial involving more than 6,000 adults with type 2 diabetes at high risk for heart problems compared two blood glucose–lowering drugs: the DPP-4 inhibitor linagliptin (Tradjenta), which previous studies had shown to be safe for the heart, and the sulfonylurea glimepiride (Amaryl). Participants prescribed daily glimepiride had about the same rates of heart attack–, stroke-, or heart disease–related death combined as those who took linagliptin, about 12 percent in each group. However, with glimepiride, low blood glucose (hypoglycemia) was about three times more common (38 percent versus 11 percent), and the glimepiride group gained more weight, resulting in about a 4-pound difference. On the other hand, glimepiride is far less expensive. Be sure to discuss all your options with your doctor.
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Source: JAMA, published online Sept. 19, 2019