Newer Sulfonylureas Not Associated with Increased Mortality, MIs, or Strokes


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Am Fam Physician. 2016 Sep 1;94(5):386.

Clinical Question

Are newer-generation sulfonylureas associated with bad outcomes in patients with type 2 diabetes mellitus?

Bottom Line

In multiple randomized trials, the long-term use of second- or third-generation sulfonylureas in patients with type 2 diabetes is not associated with more deaths, myocardial infarctions (MIs), or strokes. The included trials tended not to report other safety data. (Level of Evidence = 1a)


These authors reviewed two databases and the Cochrane Library to identify randomized trials of second- or third-generation sulfonylureas in patients with type 2 diabetes. Additionally, they searched for unpublished studies by looking at clinical trial registries and the abstracts of international diabetes meetings. The trials had to be at least one year in duration and evaluate all-cause or cardiovascular mortality.

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


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Oct 15, 2016

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