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A Chinese research study of diabetes patients with coronary heart disease concludes that metformin is more effective than glipizide in reducing the risk of major cardiovascular events, such as stroke and heart attack.
Researchers at the Shanghai Jiao Tong University School of Medicine studied 304 patients, ages 36 to 80, over a five-year period. The patients were randomly assigned either the sulfonylurea glipizide (30 mg daily) or metformin (1.5 g daily) for three years.
At the start of the study, the baseline A1c for the overall patient group was 7.6%. Within six months, the A1c for the glipizide group fell to 7.1% and to 7.0% for the metformin group.
By the end of the study, 35.1 percent of patients on glipizide had experienced a CV event compared with 25 percent of the patients taking metformin.
Researchers said that this was the first known head-to-head comparison of the two drugs' ability to affect the incidence of CV events. Glipizide, or similar sulfonylureas, and metformin are the drugs doctors are most likely to prescribe to newly diagnosed diabetes patients.
On explanation for metformin's superior performance may be that it has antiatherosclerotic properties-the ability to help blood vessels resist the hardening associated with diabetic inflammation.
An abstract of the study is available online.
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