A new study conducted by researchers at Mass General Brigham has raised concerns over Glipizide, a widely used sulfonylurea for type 2 diabetes.
Analysing data from 48,165 patients across ten study sites in the US, the team found that Glipizide was associated with a 13 per cent increase in cardiovascular risk compared to dipeptidyl peptidase-4 (DPP-4) inhibitors.
The research indicated a higher rate of heart failure, hospitalisations, and cardiovascular deaths in patients using Glipizide alongside metformin, the standard first-line diabetes drug.
Other sulfonylureas, such as glimepiride and glyburide, showed comparatively lower or unclear effects.
According to lead author Alexander Turchin from the Division of Endocrinology at Brigham and Women’s Hospital, patients with type 2 diabetes are already at an elevated risk of adverse cardiovascular events, including coronary ischemia, stroke, and heart failure.
Therefore, treatment choices must balance blood sugar control with long-term heart health.
Turchin emphasised that although sulfonylureas are popular and cost-effective, their impact on cardiac outcomes remains insufficiently studied compared to more neutral drugs such as DPP-4 inhibitors.
He noted that this research highlights the need to evaluate each medication individually rather than assuming uniform effects within the same drug class.
Implications for Diabetes Care
Type 2 diabetes continues to grow worldwide, making the management of cardiovascular risk a crucial part of patient care.
The findings of this study suggest that physicians should carefully consider cardiovascular profiles when prescribing sulfonylureas, particularly Glipizide, to patients with moderate or high heart risk.
Moreover, the study underscores the importance of long-term comparative trials to understand the safety of commonly prescribed drugs.
While Glipizide remains effective for glucose control, the potential trade-off in cardiac health warrants caution and further research.
The authors called for additional studies to explore the underlying mechanisms that may explain the increased cardiovascular risk linked to Glipizide. They also suggested examining diverse populations and longer follow-ups to confirm the findings and inform clinical guidelines.
As the prevalence of type 2 diabetes rises, the balance between managing blood sugar and protecting heart health remains central to treatment strategies.
This study adds to growing evidence urging personalised approaches to diabetes care, ensuring patients receive medications that optimise both metabolic and cardiovascular outcomes.
By distinguishing Glipizide from other sulfonylureas, the research opens the door for more nuanced prescribing practices and reinforces the need to continuously reassess long-standing medications in light of evolving evidence.
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