The trick to switching antidiabetic drugs

Continuing metformin when introducing sulfonylureas is best

For patients with type 2 diabetes, switching from metformin to a sulfonylurea in a bid to better control blood sugar is associated with an increased risk of complications, Canadian researchers warn.

Instead, patients should be advised to continue on metformin when introducing sulfonylureas, they say.

In their study of 77,000 patients with type 2 diabetes, the investigators have found that sulfonylureas as second-line drugs are associated with an increased risk of myocardial infarction, all-cause mortality and severe hypoglycaemia, compared with remaining on metformin monotherapy.

The researchers also note a trend towards increased risks of ischaemic stroke and cardiovascular death with sulfonylurea use.

“Importantly, the observed associations with myocardial infarction and all cause mortality were driven by the switching to sulfonylureas and not the addition of sulfonylureas,” write McGill University