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In This Issue of JAMA
September 24, 2019


JAMA. 2019;322(12):1121-1123. doi:10.1001/jama.2018.15520

The dipeptidyl peptidase 4 inhibitor linagliptin has not been tested against an active comparator for cardiovascular outcomes in patients with type 2 diabetes. For the CAROLINA Investigators, Rosenstock and colleagues randomized 6042 adults who had type 2 diabetes with elevated cardiovascular risk and found that the use of linagliptin, compared with glimepiride, over a median 6.3 years resulted in a noninferior risk of a composite cardiovascular outcome. In an Editorial, Wexler compares new classes of glucose-lowering medications vs metformin and sulfonylureas.

Editorial and Related Article

Visual Abstract

The effectiveness of metformin on clinical outcomes for patients with diabetes and reduced kidney function is unknown. Roumie and colleagues conducted a retrospective cohort study of 96 725 new users of metformin or sulfonylureas who had reduced kidney function and found that treatment with metformin was associated with a lower risk of major adverse cardiovascular events.