Author Interviews, Diabetes, Heart Disease, JAMA, Vanderbilt / 10.06.2014
Diabetes: Adding Insulin To Metformin May Increase Cardiovascular Risk
MedicalResearch.com Interview with:
Christianne L. Roumie, MD MPH
Associate Professor Internal Medicine and Pediatrics
Institute for Medicine and Public Health
Vanderbilt University
Staff Physician VA Tennessee Valley Healthcare System
Nashville TN 37212
MedicalResearch: What are the main findings of the study?
Dr. Roumie: This retrospective cohort study compared time to acute myocardial infarction (AMI), stroke, or death among Veterans with diabetes that were initially treated with metformin, and subsequently added either insulin or sulfonylurea. Among 178,341 Veterans on metformin monotherapy, 2,948 and 39,990 added insulin or sulfonylurea, respectively. Patients were about 60 years old, about 35% had history of heart disease or stroke, had been on metformin for an average of 14 months and their hemoglobin A1c was 8.1% at the time of addition of the second medication. Compared to those who added a sulfonylurea, those who added insulin to metformin had a 30% higher risk of the combined outcome of heart attack, stroke, and all-cause mortality. Although new heart attacks and strokes occurred at similar rates in both groups, mortality was higher in patients who added insulin.
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