Sulphonylureas, a type of drug widely used to treat type 2 diabetes, has a greater risk of causing heart failure and death as compared to metformin, another popular antidiabetes drug, according to a study.
The findings suggest that clinically important differences in the cardiovascular safety profiles of different antidiabetes drugs, and support recommendations that favour metformin as first-line therapy for type 2 diabetes.
Type 2 diabetes affects more than 180 million people worldwide and is associated with at least a two-fold increased risk of death, mainly from cardiovascular disease.
Oral antidiabetes drugs are widely used to help control blood sugar levels, but there are concerns that some may increase cardiovascular risk.
Thus, researchers led by Professor Paul Elliott from Imperial College London set out to investigate the risk of heart attack (myocardial infarction), congestive heart failure and death from any cause associated with prescription of different types of oral antidiabetes drugs.
They used data from 91,521 men and women (average age 65 years) with diabetes included in the UK General Practice Research Database between 1990 and 2005 and took into account factors that could potentially affect the results.
Metformin was the most commonly prescribed drug, followed by second generation sulphonylureas. Compared with metformin, both first and second generation sulphonylureas were linked with significant excess risk of all cause mortality, and second generation sulphonylureas with up to 30 percent excess risk of congestive heart failure.
Another class of antidiabetes drugs called thiazolidinediones were not associated with risk of heart attack, and there was significantly lower risk of all cause mortality associated with pioglitazone use compared with metformin.
"The sulphonylureas, along with metformin, have long been considered the mainstay of drug treatment for type 2 diabetes. Our findings suggest a relatively unfavourable risk profile of sulphonylureas compared with metformin," the British Medical Journal quoted the authors as saying.
SOURCE
Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts
Sunday, December 6, 2009
Monday, November 23, 2009
Diabetes Debate : Diabetes Symptoms and Cost
In the bitter debate about health care, here's one thing many people agree on: The U.S. spends too much on health care, and much of it could be avoided.
Diabetes is one of the big examples.
About 20 percent of health care spending goes to people with diabetes. The number of people with diabetes nearly doubled from 1995 to 2006. About 8 percent of Pennsylvania residents have the disease. About half of people with diabetes receive taxpayer-funded health care through programs including Medicare.
In theory, it might seem easy to slash the diabetes-related expense. The disease is often the result of lifestyle. People exercise too little and eat too much. They become obese and then diabetic. In reality, that's hard to change. American culture tends to encourage minimal activity and overeating. Despite the alarm about obesity, rates of obesity and diabetes are rising.
Pennsylvania is mounting an effort to improve the health of diabetics and reduce the expense. The effort, backed by the Rendell administration, is called the Pennsylvania Diabetes Action Plan. So far, it involves about 100 medical practices, and the goal is to make the approach standard among family doctors.
The effort involves promoting a team approach to caring for diabetes patients and making sure they get tests and other support needed to control the disease. Health insurers are involved.
A goal is to adjust the payment system to encourage medical practices to provide the best care for diabetics and reward good results.
Dr. Robert Gabbay heads the diabetes clinic at Penn State Milton S. Hershey Medical Center, where he has worked for 11 years. Gabbay, 51, is one of the leaders of the diabetes plan.
He recently discussed diabetes and the plan. (Gabbay's responses have been summarized.)
Why do so many people have diabetes, and why is it rising?
SOURCE
Diabetes is one of the big examples.
About 20 percent of health care spending goes to people with diabetes. The number of people with diabetes nearly doubled from 1995 to 2006. About 8 percent of Pennsylvania residents have the disease. About half of people with diabetes receive taxpayer-funded health care through programs including Medicare.
In theory, it might seem easy to slash the diabetes-related expense. The disease is often the result of lifestyle. People exercise too little and eat too much. They become obese and then diabetic. In reality, that's hard to change. American culture tends to encourage minimal activity and overeating. Despite the alarm about obesity, rates of obesity and diabetes are rising.
Pennsylvania is mounting an effort to improve the health of diabetics and reduce the expense. The effort, backed by the Rendell administration, is called the Pennsylvania Diabetes Action Plan. So far, it involves about 100 medical practices, and the goal is to make the approach standard among family doctors.
The effort involves promoting a team approach to caring for diabetes patients and making sure they get tests and other support needed to control the disease. Health insurers are involved.
A goal is to adjust the payment system to encourage medical practices to provide the best care for diabetics and reward good results.
Dr. Robert Gabbay heads the diabetes clinic at Penn State Milton S. Hershey Medical Center, where he has worked for 11 years. Gabbay, 51, is one of the leaders of the diabetes plan.
He recently discussed diabetes and the plan. (Gabbay's responses have been summarized.)
Why do so many people have diabetes, and why is it rising?
SOURCE
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