Key result
Initiation of glipizide as second-line therapy in patients with type 2 diabetes was associated with a higher 5-year risk of MACE-4 compared to DPP4 inhibitors (RR 1.13; 95% CI 1.03-1.23).
Why the study?
Sulfonylureas are commonly used for type 2 diabetes, but research findings on their associated cardiovascular risk have been inconsistent.
Does initiation of a sulfonylurea compared to a DPP4 inhibitor increase the risk of major adverse cardiovascular events in patients with type 2 diabetes on metformin?
Cohort (n=48,165)
Yes
Does initiation of a sulfonylurea compared to a DPP4 inhibitor increase the risk of major adverse cardiovascular events in patients with type 2 diabetes on metformin?
Relative Risk: 1.13 (95% CI 1.03–1.23)
Absolute Event Rate: 9.1% vs 8.1%
In patients with type 2 diabetes on metformin, second-line treatment with glipizide is associated with a significantly higher 5-year risk of major adverse cardiovascular events compared to DPP4 inhibitors.
No takes yet. Share an insight, caveat, or question.
Supports caution with glipizide versus DPP4 inhibitors in type 2 diabetes; leaves open causal confirmation in randomized trials.
Turchin et al. (2025) conducted a cohort in Type 2 diabetes (n=48,165). Sulfonylureas (glipizide, glimepiride, or glyburide) vs. Dipeptidyl peptidase 4 inhibitors (DPP4is) was evaluated on 4-point composite of major adverse cardiovascular events (MACE-4): myocardial infarction, ischemic stroke, heart failure hospitalization, or cardiovascular death (RR 1.13, 95% CI 1.03-1.23). Initiation of glipizide as second-line therapy in patients with type 2 diabetes was associated with a higher 5-year risk of MACE-4 compared to DPP4 inhibitors (RR 1.13; 95% CI 1.03-1.23).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: