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In the June issue of Diabetologia: the Journal of the European Association for the Study of Diabetes, researchers argued whether sulphonylurea drugs (such as Micronase, Glucotrol, DiaBeta, Glynase, Amaryl and Diabinese) pose an increased cardiovascular risk for individuals with type 2 diabetes and heart disease. (Sulphonylurea drugs are prescribed to help stimulate the beta cells of individuals with type 2 diabetes; it may also increase the sensitivity of muscle tissue to the hormone.)
In a letter to the editor, P. Fasching, MD, of the Department of Internal Medicine from Vienna, Austria, dismissed earlier claims made by University of Dusseldorf researchers, M. Berger, I. Muluhlhauser, and P.T. Sawicki, that sulphonylurea drugs cause increased risk of heart attack. The Dusseldorf team had cited evidence suggesting such a risk existed, including a study that compared use of the drug to conventional insulin treatment in a group of heart disease patients. In this study, the insulin group had lower mortality rates than the sulphonylurea users.
Fasching, citing other evidence, claimed that use of sulphonylureas did not pose an increased cardiovascular risk, and dismissed the Dusseldorf team's claim as "mere speculation."
In response to Fasching's comments, the Dusseldorf team agreed that studies demonstrating the cardiovascular risks of sulphonylureas are not definitive. Nevertheless, they claim, "recent findings in animal and humans have provided a pathophysiological plausibility for our hypothesis."
In particular, the team emphasized that the drugs damage artery walls and cause an accumulation of plaque that clogs the vessels. The team concluded that "the-albeit incomplete-evidence implementing a cardiotoxic effect of sulphonylurea drugs has become substantial enough to shift the burden of proof... to document that this is actually safe."
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