The University Group Diabetes Program Study Pertaining to Phenformin

The University Group Diabetes Program (UGDP) reports in this issue ofThe Journalan eight-year study in which cardiovascular and total mortality in adult-onset diabetics treated with phenformin were significantly higher than in patients treated with insulin or with a placebo. The UGDP concludes that "phenformin was no more effectual than diet alone or than diet and insulin in prolonging life" or... "in preventing the occurrence of nonfatal vascular complications associated with diabetes." The UGDP study is a pioneer effort to improve the methodology of clinical therapeutic trials. However, this study was not primarily designed to examine cardiovascular mortality, and detailed information concerning certain factors which are believed to influence death from cardiovascular disease was not obtained when the patients were admitted to the study. Nevertheless, the increased mortality from all causes, and from cardiovascular disease in particular, in the group treated with phenformin is a matter of grave concern.