Sulfonylureas, Pioglitazone Similarly Safe for Add-On Therapy in Type 2 Diabetes — Physician’s First Watch
Sulfonylureas, Pioglitazone Similarly Safe for Add-On Therapy in Type 2 Diabetes
By Amy Orciari Herman
Edited by Susan Sadoughi, MD
For patients with type 2 diabetes inadequately controlled with metformin, add-on treatment with either a sulfonylurea or pioglitazone seems similarly safe over the long-term, according to an open-label, multicenter study in the Lancet Diabetes & Endocrinology.
Over 3000 Italian patients aged 50–75 with hemoglobin A1c levels of 7%–9% despite metformin treatment were randomized to add a sulfonylurea (e.g., glimepiride) or pioglitazone to their regimen. Participants were followed for a median of nearly 5 years.
The primary outcome — a composite of all-cause mortality, nonfatal myocardial infarction, nonfatal stroke, or urgent coronary revascularization — occurred in 7% of patients in each group. Neither the composite outcome nor its individual components differed significantly between the groups.
The incidences of heart failure, bladder cancer, and fracture were similar in the two groups. Hypoglycemia occurred more often with sulfonylureas.
The authors conclude, "Both of these widely available and affordable treatments are suitable options with respect to efficacy and adverse events."