Association of sulphonylurea treatment with all-cause and cardiovascular mortality: A systematic review and meta-analysis of observational studies

Forst, Thomas; Hanefeld, Markolf; Jacob, Stephan; Moeser, Guido; Schwenk, Gero; Pfützner, Andreas; Haupt, Axel

doi:10.1177/1479164112465442

Cited by 77 publications

(49 citation statements)

References 69 publications

(93 reference statements)

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“…ORIGIN on the other hand provided evidence that insulin initiated early in the course of type-2 diabetes does not generally increased of hypoglycaemia [47]. Generally sulfonylurea are perceived to be associated with increased cardiovascular risk [85]. Interestingly, it was demonstrated that a specific sulfonylurea, glibenclamide (also known as glyburide), was associated with a lower risk of CV complications compared to treatment using metformin (belonging to the biguanide class) or rosiglitazone (thiazolidinedione class) in T2D [86].…”

Section: Resultsmentioning

confidence: 99%

Cardiac implications of hypoglycaemia in patients with diabetes – a systematic review

Hanefeld

Duetting

Bramlage

2013

Cardiovasc Diabetol

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BackgroundHypoglycaemia has been associated with increased cardiovascular (CV) risk and mortality in a number of recent multicentre trials, but the mechanistic links driving this association remain ill defined. This review aims to summarize the available data on how hypoglycaemia may affect CV risk in patients with diabetes.MethodsThis was a systematic review of available mechanistic and clinical studies on the relationship between hypoglycaemia and cardiovascular risk. Study outcomes were compiled from relevant articles, and factors contributing to hypoglycaemia-mediated CVD and its complications are discussed.ResultsSix recent comprehensive clinical trials have reinforced the critical importance of understanding the link between hypoglycaemia and the CV system. In addition, 88 studies have indicated that hypoglycaemia mechanistically contributes to CV risk by increasing thrombotic tendency, causing abnormal cardiac repolarization, inducing inflammation, and contributing to the development of atherosclerosis. These hypoglycaemia-associated risk factors are conducive to events such as unstable angina, non-fatal and fatal myocardial infarction, sudden death, and stroke in patients with diabetes.ConclusionsEmerging data suggest that there is an impact of hypoglycaemia on CV function and mechanistic link is multifactorial. Further research will be needed to ascertain the full impact of hypoglycaemia on the CV system and its complications.

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Section: Resultsmentioning

confidence: 99%

Cardiac implications of hypoglycaemia in patients with diabetes – a systematic review

Hanefeld

Duetting

Bramlage

2013

Cardiovasc Diabetol

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“…The presence of similar channels in vascular tissue has raised concerns about the effects of some sulfonylureas on cardiac vascular tissue and adverse outcomes. 34,35 In contrast to metformin's insulin-sensitizing effects, the sulfonylureas address reduced b-cell function and stimulate insulin secretion providing a complimentary mechanism for glucose-lowering. They are cost-effective and have clinical trial evidence for reducing microvascular complications in type 2 diabetes (United Kingdom Prospective Diabetes Study), although the reduction in cardiovascular events was not significant.…”

Section: Sulfonylureasmentioning

confidence: 98%

Current Therapies for the Medical Management of Diabetes

Inzucchi

Majumdar²

2016

Obstetrics &Amp; Gynecology

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Diabetes affects a large and diverse number of individuals who share in common its risks for complications but who differ greatly from one another in age, health, and a number of circumstances influential to successful treatment. Because type 2 diabetes comprises the majority of diabetes cases, a number of agents have been developed for its treatment. Their unique properties offer opportunities to overcome some of the treatment limitations of older medicines and enable a more individualized and flexible approach to glucose-lowering. At the same time, new medications are accompanied by greater costs and uncertainties about their long-term benefits or safety, and thus the present state of care for type 2 diabetes places focus on a process of shared decision-making between the clinician and patient as to which treatments can optimize health while minimizing harms. We review the major classes of diabetes agents and provide some guidance for how one might approach decision-making in choosing among them.

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“…La reciente disponibilidad de nuevos antidiabéticos como los inhibidores de dipeptidil-peptidasa-IV, los análogos del péptido similar al glucagón tipo 1 y los inhibidores del transportador de sodio-glucosa tipo 2, aunado a estudios que muestran un probable incremento del riesgo de la mortalidad cardiovascular y por todas las causas en los pacientes manejados con sulfonilurea 32 , está llevando a un cambio en las prácticas de prescripción 4 .…”

Section: Discussionunclassified

Evaluación de la prescripción de glibenclamida en diabéticos tipo 2

Castro¹,

Estrada

Goez

2017

revsal

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RESUMENIntroducción: Las sulfonilureas permanecen junto con la metformina como el tratamiento farmacológico más usado para los pacientes diabéticos tipo 2, y continúan siendo los antidiabéticos más prescritos en algunas regiones del mundo. Objetivo: Evaluar la prescripción de glibenclamida en aspectos relacionados a contraindicaciones, dosificación, y prevención de efectos adversos, en el tratamiento de los pacientes diabéticos tipo 2 que acuden a una institución de salud de baja complejidad en Cartagena de Indias, Colombia. Metodología: Estudio descriptivo con enfoque desde la fármaco-epidemiología dirigido específicamente al campo de los estudios de utilización de medicamentos, basado en los datos recogidos mediante revisión de historias clínicas de 331 pacientes diabéticos tipo 2, mayores de 18 años en un centro de atención primaria en salud de la ciudad de Cartagena de Indias entre los años 2013 y 2014. Se estudiaron variables demográficas, clínicas y paraclínicas, el esquema terapéutico y la calidad de la prescripción. La información se analizó usando estadística descriptiva. Resultados: 57 % (189) de los pacientes utilizaron glibenclamida siendo un 59.3 % (153) prescrito de manera inadecuada, 45.5% (86) tenían alguna contraindicación para el empleo del medicamento. En 1 % de los pacientes de la muestra se prescribió sobrepasando el rango de dosis terapéutica Conclusiones: La calidad de la prescripción de la glibenclamida fue inadecuada en una proporción importante de pacientes, se hace necesario implementar estrategias educacionales que capaciten al personal médico para una correcta utilización de los fármacos antidiabéticos. La glibenclamida comparada con otras sulfonilureas de segunda generación nos brinda más desventajas que ventajas.Palabras Clave: Diabetes Mellitus Tipo 2, glibenclamida, contraindicaciones, tasa de filtración glomerular, prescripciones de medicamentos, farmacoepidemiología. ABSTRACTIntroduction: Sulfonylureas remain with metformin as the most used drug treatment for type 2 diabetic patients and remain the most prescribed anti-diabetic in some regions of the world. Target: Evaluate prescribing glyburide in aspects related to contraindications, dosage, and prevention of adverse effects, in the treatment of type 2 diabetic patients attending a health institution low complexity in Cartagena de Indias, Colombia. Methodology: Descriptive study with approach from the pharmaco-epidemiology specifically directed to the field of studies of drug use, based on the data collected through review of medical records of 331 type 2 diabetic patients over 18 years in a primary

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Association of sulphonylurea treatment with all-cause and cardiovascular mortality: A systematic review and meta-analysis of observational studies

Cited by 77 publications

References 69 publications

Cardiac implications of hypoglycaemia in patients with diabetes – a systematic review

Cardiac implications of hypoglycaemia in patients with diabetes – a systematic review

Current Therapies for the Medical Management of Diabetes

Evaluación de la prescripción de glibenclamida en diabéticos tipo 2

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