Canadian researchers have revived a decades-old concern about whether sulfonylurea drug use can cause adverse cardiac events.1,2 They followed a cohort of 5795 patients with type 2 diabetes over an average of 4.6 years.1 All subjects were only taking one of three types of oral anti-diabetic agent — a first generation sulfonylurea (chlorpropamide or tolbutamide), a more recently developed sulfonylurea (glibenclamide), or metformin. The researchers found that the higher the daily dose of sulfonylurea (especially a first-generation sulfonylurea), the greater the risk of death, including death caused by an acute ischaemic event. This association was not found with metformin.
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