Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.


Subscribe or Register

Existing user? Login


Sulfonylureas and basal insulin linked to elevated cardiovascular risk

Analysis of data from more than 132,000 patients finds common treatments for type 2 diabetes mellitus can significantly elevate the risk of cardiovascular events.

Woman injecting insulin


Use of basal insulin to control type 2 diabetes was associated with more than a two-fold increased risk of cardiovascular events compared with DPP-4 inhibitors, study finds

Sulfonylureas and basal insulin confer an increased risk of cardiovascular events compared with newer second-line medicines for type 2 diabetes mellitus (T2DM), research has found[1].

A study in JAMA Network Open (21 December 2018) used US insurance data to compare cardiovascular events in 132,737 adults who began taking a second-line antidiabetic therapy, with or without first-line metformin.

Overall, there were 3,480 cardiovascular events during 169,384 person-years of follow-up. After adjustment for confounding factors, the risk of cardiovascular events was similar between dipeptidyl peptidase 4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter 2 inhibitors and thiazolidinediones.

However, second-line basal insulin was associated with more than a two-fold increased risk of cardiovascular events, and sulfonylureas with a 36% increased risk, compared with DPP-4 inhibitors.

The researchers said their findings raised concerns that the use of these older drug classes may contribute to cardiovascular harms in T2DM. 

“This should force providers to think about the cardiovascular effects of these drugs early in the course of diabetes treatment, and shift prescribing patterns to newer drugs that have more favorable cardiovascular profiles,” said lead author Matthew O’Brien from Northwestern University, Illinois. 

Citation: Clinical Pharmacist DOI: 10.1211/CP.2019.20206062

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • BNF and BNF for Children

    BNF and BNF for Children

    Now available as a 2 year print subscription to both the BNF and BNFC, ensuring you have the latest medicines information as it publishes and at a greatly reduced price.

    £262.50Buy now
  • Essentials of Economic Evaluation in Healthcare

    Essentials of Economic Evaluation in Healthcare

    An introduction to economic evaluation specific to healthcare, for those with little or no knowledge of economics. Covers cost effectiveness, cost utility and cost benefit analysis.

    £33.00Buy now
  • Sport and Exercise Medicine for Pharmacists

    Sport and Exercise Medicine for Pharmacists

    All the information you need to provide patients with evidence-based advice on sports and exercise related health matters.

    £27.00Buy now
  • Workplace Drug Testing

    Workplace Drug Testing

    Explains drug testing regulatory frameworks and all aspects of drug analysis. Case studies of successful programmes are included.

    £81.00Buy now
  • Drugs and the Liver

    Drugs and the Liver

    Drugs and the Liver assists practitioners in making pragmatic choices for their patients. It enables you to assess liver function and covers the principles of drug use in liver disease.

    £38.00Buy now

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Jobs you might like

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.