Glipizide, glimepiride, and glyburide were recently compared to metformin in patients with coronary artery disease. The safest drug was metformin and all experts agree that today it should be the first line drug prescribed for type 2 diabetics.
This research is relevant because diabetes is on the increase and sulfonylureas are widely prescribed to many diabetics. Until recently, these drugs were all felt to be similar in effectiveness and safety, but now this research reveals otherwise. Metformin is now available as a generic, is very affordable, and is an excellent drug for blood glucose control. However, in patients with coronary disease, glimepiride may be the preferred drug.
Overall, glipizide and glimepiride are preferred over glyburide, but metformin should be the drug of choice in most type 2 diabetics.
Even though sulfonylureas have been available for many years, it appears that we still don’t know much about them. It’s important for consumers not to stop taking their medications and to speak to their physicians before doing so.
Contributed by Dr. Steven Bhimji, M.D.