Print | Email | Share | Comments (0)

Metformin Is Still Tops for Diabetes, Says Study Review

Linda von Wartburg

Aug 8, 2007

That old standby, metformin, is still your best bet. In fact, there is no benefit in taking the newer oral medications unless you can't tolerate the older ones.

That was the conclusion of researchers from Johns Hopkins University who examined 216 controlled studies and two systematic reviews in order to compare older oral medicines (second-generation sulfonylureas and metformin) and newer medications (thiazolidinediones, meglitinides, and alpha-glucosidase inhibitors) with regard to medium-term effects on A1c levels, lipid levels, body weight, and adverse outcomes.

Overall, the researchers found metformin to have the best benefit to risk ratio. Metformin was similar to or even better than the other oral medicines with regard to blood sugar control and lipid levels, though it was associated with greater risk of gastrointestinal problems.

In addition, it did not cause the 2.2 to eleven pound weight gain associated with almost all the other medicines. Second-generation sulfonylureas did pretty well too, apart from a greater risk of hypoglycemia.

Compared with newer agents, both metformin and sulfonylureas had three distinct advantages: longer use in practice, more information about longer-term effects, and lower cost. Metformin is available generically for about $40 monthly, for example, while Avandia can cost over $250 monthly.

Thiazolidinediones (like Actos and Avandia) were found to have a lower risk for hypoglycemia and a small beneficial effect on healthy cholesterol (HDL) levels, but were no better at lowering blood glucose and were also associated with adverse effects on bad cholesterol (LDL), weight, and risk of congestive heart failure.

(The researchers noted that large, longer-term comparative studies are still needed on outcomes such as myocardial infarction, chronic kidney disease, and cardiovascular mortality, as this review focused only on medium-term effects.)

The study review, which was commissioned in May 2005 by the federal Agency for Healthcare Research and Quality, has been used by Consumer Reports as the basis for its "best buy" evaluations of oral diabetes medications. In sum, Consumer Reports concluded that newer drugs are no better, no safer, and certainly more expensive.

Sources: Annals of Internal Medicine, September 2007
Medline Plus

Categories: A1c Test, Blood Sugar, Diabetes, Diabetes, Low Blood Sugar, Metformin, Type 2 Medications

Comments

Add your comments about this article below. You can add comments as a registered user or anonymously. If you choose to post anonymously your comments will be sent to our moderator for approval before they appear on this page. If you choose to post as a registered user your comments will appear instantly.

When voicing your views via the comment feature, please respect the Diabetes Health community by refraining from comments that could be considered offensive to other people. Diabetes Health reserves the right to remove comments when necessary to maintain the cordial voice of the diabetes community.

For your privacy and protection, we ask that you do not include personal details such as address or telephone number in any comments posted.

Don't have your Diabetes Health Username? Register now and add your comments to all our content.

Have Your Say...

Registered User Anonymous

Your Name:	Your Email:	X

Recipient's Name:	Recipient's Email:

Your Chosen Username:	Your Email Address:

Chosen Password:	Confirm Password:

Email to a Friend

Metformin Is Still Tops for Diabetes, Says Study Review

You May Also Be Interested In...

Comments

Register...

Have Your Say...

Diabetes Health

Topics

Topics

Topics

Diabetes Health Medical Disclaimer

Comment: