The Medical Letter on Drugs and Therapeutics
Addendum: What Comes After Metformin for Type 2 Diabetes?
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Med Lett Drugs Ther. 2012 Aug 6;54(1396):64
 Select a term to see related articles  insulin   metformin   Sulfonylureas   type 2 diabetes 

Several readers have raised questions about the statement in our recent article (Med Lett Drugs Ther 2012; 54:58) that long-acting insulins, like metformin and sulfonylureas, have been shown to decrease long-term cardiovascular risk. Our statement was based on the extension of the UKPDS (RR Holman et al, N Engl J Med 2008; 359:1577), which is the longest prospective trial of drug therapy in patients with type 2 diabetes. Shorter studies in older patients with long-standing diabetes did not find a reduction in cardiovascular risk with these and other drugs (The Action to Control Cardiovascular Risk in Diabetes Study Group. N Engl J Med 2008; 358:2545; The ADVANCE Collaborative Group. N Engl J Med 2008; 358:2560; W Duckworth et al. N Engl J Med 2009; 360:129).

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