Metformin vs. Sulfonylureas in Early Reduced Kidney Function

Metformin vs. Sulfonylureas in Early Reduced Kidney Function 

By Kelly Young

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Metformin has a better cardiovascular safety profile than sulfonylureas in patients with diabetes and reduced kidney function, according to a JAMA study that is being presented at the European Association for the Study of Diabetes annual meeting.

Researchers used Veterans Affairs data to compare 25,000 new metformin users with 25,000 new sulfonylurea users who developed reduced kidney function (elevated serum creatinine or reduced estimated glomerular filtration rate) and continued their treatment. During a median 1 year of follow-up, the rate of major adverse cardiovascular events was significantly lower with metformin than with sulfonylureas (23 vs. 29 events per 1000 person-years).

An editorialist writes: "The study further supports the use of metformin as the first-line treatment to which other diabetes medications are added, even as early chronic kidney disease develops."

JAMA article (Free)

JAMA editorial (Subscription required)

Background: NEJM Journal Watch General Medicine coverage of whether to add or switch to sulfonylureas (Free)

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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