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September 19, 2019

Sulfonylureas and Cardiovascular Safety: The Final Verdict?

Author Affiliations
  • 1Diabetes Center, Massachusetts General Hospital, Harvard Medical School, Boston
JAMA. 2019;322(12):1147-1149. doi:10.1001/jama.2019.14533

As the options for glucose-lowering medications for patients with type 2 diabetes have expanded, the choices for physicians and patients have become more difficult. Owing to a 2008 US Food and Drug Administration mandate, more than 20 randomized, mostly placebo-controlled, cardiovascular outcomes trials (CVOTs) of new glucose-lowering medications have been published in the last 5 years,1 prompting a shift in prescribing recommendations for medication management in patients with type 2 diabetes and established atherosclerotic cardiovascular disease.2 One of the most important findings to emerge from this set of trials—regarding the cardiovascular safety of sulfonylureas—is published in this issue of JAMA. A second article, a retrospective cohort study also published in this issue, expands current understanding of the cardiovascular safety of metformin and sulfonylurea use in early chronic kidney disease.