Insulin-Metformin Combo Tied to Poorer Survival in Diabetes Study

"The current study suggests that adding a sulfonylurea to metformin should be preferred to adding insulin for most patients who need a second diabetes drug," she said. Sulfonylureas include glibenclamide (Micronase), glimepiride (Amaryl), glipizide (Glucotrol) and others. They work by stimulating the body to make more insulin. Roumie's team found that, compared with those who added a sulfonylurea, those who added insulin to metformin had 30 percent higher odds of heart attack, stroke and death from any cause during the study period. "Although new heart attacks and strokes occurred at similar rates in both groups, mortality was higher in patients who added insulin," she said. Roumie said she doesn't know why the rate of deaths was higher among study patients taking insulin. "We have a number of studies planned to examine possible mechanisms. We are investigating type 2 diabetes outcomes associated with blood sugar swings and with episodes of hypoglycemia (low blood sugar) tied to insulin," she said. Sulfonylureas can also cause low blood sugar levels, according to the American Diabetes Association. The report was published June 11 in the Journal of the American Medical Association.
http://health.usnews.com/health-news/articles/2014/06/10/insulin-metformin-combo-tied-to-poorer-survival-in-diabetes-study