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Comment & Response
October 22/29, 2014

Insulin vs Sulfonylureas for Second-Line Diabetes Treatment

Author Affiliations
  • 1Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
JAMA. 2014;312(16):1693. doi:10.1001/jama.2014.11114

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.