To the Editor Dr Roumie and colleagues1 reported that compared with sulfonylureas the addition of insulin to metformin to improve glycemic control was associated with an increased risk of a composite of nonfatal cardiovascular outcomes and all-cause mortality in patients with diabetes mellitus. Although the results presented require verification in carefully designed clinical trials, we have some concerns about the current analyses.
Tasci I, Safer U. Insulin vs Sulfonylureas for Second-Line Diabetes Treatment. JAMA. 2014;312(16):1693. doi:10.1001/jama.2014.11114