Review supports use of metformin as first-line therapy for patients without other contraindications
Research Activities, December 2012, No. 388
New research from the Effective Health Care Program of the Agency for Healthcare Research and Quality examined metformin and sulfonylureas use among patients beginning to take oral medications to treat type 2 diabetes. The use of sulfonylureas was associated with an increased risk of cardiovascular disease (CVD) events—including death—among study patients compared with metformin use. Further studies would be needed to clarify whether the difference in risk is due to harms from sulfonylureas, benefits from metformin, or both.
While previous studies have shown that metformin seems to have fewer serious CVD events than sulfonylureas, this is one of the first large-scale data analyses to come to this conclusion. The study examined more than 250,000 records from the U.S. Department of Veterans Affairs. The findings support the use of metformin for first-line type 2 diabetes therapy for patients without other contraindications and contribute to our knowledge about the cardiovascular advantages of metformin compared with sulfonylureas.
See "Comparative Effectiveness of Sulfonylurea and Metformin Monotherapy on Cardiovascular Events in Type 2 Diabetes Mellitus," by Christianne L. Roumie, M.D., M.P.H., Adriana M. Hung, M.D., M.P.H., Robert A. Greevy, Ph.D., and others in the November 2012 Annals of Internal Medicine 157(9), pp. 601-610.