Old Diabetes Drug Has Advantages
Report: Metformin Effective With Fewer Side Effects Than Newer Drugs
Diabetes Drugs and the Heart continued...
The AHRQ report came to the same conclusion.
The researchers wrote that other than an established increase in heart
failure risk for the TDZs, the data are insufficient to show that Avandia users
are more likely than users of other diabetes drugs to have heart attacks.
They call for high-quality studies to give doctors and patients a better
idea of the risks and benefits associated with all oral diabetes drugs, either
taken alone or in combination.
A spokesperson for Actos manufacturer Takeda Pharmaceuticals declined to
comment on the report.
A spokeswoman for GlaxoSmithKline tells WebMD that there is
"absolutely no new data" in the review. She says reviewers failed to
include critical studies in their report, including the company's own ongoing
investigation of the long-term impact of Avandia on the heart.
Interim results from that trial, "add to the weight of evidence, from
both previously published long-term clinical trials and other studies, that the
overall [cardiovascular] safety profile of Avandia is comparable to traditional
antidiabetes treatments," she says.
Metformin Used First
Jean Slutsky, MSPH, of the AHRQ tells WebMD that the new report adds weight
to a 2005 recommendation from the American Diabetes Association and the
International Diabetes Federation identifying metformin as the initial
treatment for newly diagnosed, non-insulin dependent diabetes.
"Metformin does offer some advantages over some of the other drugs
prescribed for type 2 diabetes," she says. "But not all patients are
alike, and some drugs may be tolerated better by certain patients."
American Diabetes Association president Larry C. Deeb, MD, agrees the new
report should make doctors take a new look at some of the older diabetes
He adds that none of the oral diabetes drugs is particularly effective for
treating severe insulin resistance and doctors often wait too long to put
patients on insulin.
"It is not fair to patients with very out of control glucose levels to
expect their blood sugar to return to normal with oral treatments, but that is
happening all the time," he tells WebMD. "Doctors are afraid of
insulin, and as a result many patients are living with out of control