Oral Sulfonylureas: Do They Raise The Risk of Heart Disease?

With diabetes on the rise, more people are taking medications to keep their blood sugars under control and prevent the many complications associated with this disease. If you’re one of the diabetics still taking one of the older class of diabetes medications called oral sulfonylureas, you’ll want to consider this. A new study shows that people who take oral sulfonylureas may be at higher risk of heart failure, heart attack, and death compared to those who take the diabetes medication metformin.

Sulfonylureas are a class of diabetes medications that lower blood sugar levels by increasing the amount of insulin the pancreas releases. This causes higher levels of insulin to be released into the bloodstream which may be one reason why people who take oral sulfonylureas have a higher risk of heart disease. Because of the higher insulin levels, people who take them are prone to weight gain since insulin promotes fat storage. The good news is that people on sulfonylureas do lower their risk of some diabetic complications such as diabetes related eye, kidney, and nerve disease.

This particular study looked at 91, 521 women and men in the U.K. diagnosed with diabetes over a fifteen year period. They found that those who took oral sulfonylureas had up to a 61 percent increased death rate and a higher risk of heart failure compared to those who took Metformin. Heart disease is one of the most frequent causes of death in diabetics – making it crucial to reduce any other risk factors that might contribute to heart disease.

Metformin is a diabetes medication that’s been around since 1995. Rather than causing the pancreas to produce more insulin, it works by decreasing insulin resistance so the insulin that’s available can be better used  by the tissues. This results in less weight gain – in fact, metformin causess weight loss in most people. It also has the advantage of lowering cholesterol and triglyceride levels which lowers the risk of heart disease.

Sometimes Metformin is used in combination with oral sulfonylureas so that the two types of medications work as a team to control blood sugar levels. It’s not clear whether or not using oral sulfonylureas in conjunction with Metformin carries the same risk of heart failure as using sulfonylureas alone does.

There are some disadvantages to taking Metformin over the oral sulfonylureas. Metformin is more expensive and also depletes the body’s levels of B12 – an important vitamin for nerve function. It also shouldn’t be taken by people who have kidney disease since it can make this problem worse.

The bottom line? If you’re taking an oral sulfonylurea to control your blood sugar and have concerns about your heart disease risk, talk to your doctor about your options. Whatever you do, don’t stop your diabetic medications without your doctor’s permission.