Glibenclamide in combination with metformin is associated with significantly higher mortality.

Three-year mortality in diabetic patients treated with different combinations of insulin secretagogues and metformin.

Matteo Monami, Chiara Luzzi, Caterina Lamanna, Veronica Chiasserini, Filomena Addante, Carla Maria Desideri, Giulio Masotti, Niccolò Marchionni, Edoardo Mannucci

Diabetes Metab Res Rev

Nov 1, 2006

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Abstract

BACKGROUND: Several studies have shown an increase of mortality in diabetic patients treated with combinations of sulphonylureas and biguanides. Comparisons between different insulin secretagogues in combination with metformin with respect to all-cause mortality have not been reported so far. METHODS: An observational cohort study was performed on a consecutive series of 2002 outpatients with type 2 diabetes mellitus. Of these patients, 696 (34.8%) were receiving combinations of insulin secretagogues and biguanides at enrollment. Three-year mortality was assessed through research in the City of Florence Registry Office. RESULTS: During follow-up, 295 deaths were recorded. Among patients on combined secretagogue and biguanide treatment, glibenclamide was associated with a significantly higher yearly mortality (8.7%) than repaglinide (3.1%; p = 0.002), gliclazide (2.1%; p = 0.001), and glimepiride (0.4%; p

Affiliation

Department of Critical Care Medicine and Surgery, Unit of Gerontology and Geriatrics, University of Florence and Azienda Ospedaliera Vareggi, Via della Oblate 4, 50134 Florence, Italy.