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Paper in The Lancet Diabetes and Endocrinology shows glucose-lowering therapies pose increased cardiac risk
Toronto (March 17, 2015) – A comprehensive study examining clinical trials of more than 95,000 patients has found that glucose or sugar-lowering medications prescribed to patients with diabetes may pose an increased risk for the development of heart failure in these patients.
"Patients randomized to new or more intensive blood sugar-lowering drugs or strategies to manage diabetes showed an overall 14 per cent increased risk for heart failure," says Dr. Jacob Udell, the study's principal investigator, and cardiologist at the Peter Munk Cardiac Centre, University Health Network (UHN) and Women's College Hospital (WCH). "This increased risk was directly associated with the type of diabetes therapy that was chosen, with some drugs more likely to cause heart failure than others, compared with placebo or standard care," he says.
The results of the study were presented today at the American College of Cardiology's 64th Annual Scientific Session and published in the current issue of
The Lancet Diabetes and Endocrinology.
"While some drugs showed an increased risk, other strategies tested, such as intensive weight loss to control blood sugar, showed a trend towards a lower risk for heart failure," says Dr. Michael Farkouh, senior author of the study and Chair, Peter Munk Centre of Excellence in Multinational Clinical Trials, where the study was conducted.
Overall, the study found that for every one kilogram of weight gain attributed to a sugar-lowering diabetes medication or strategy, there was an associated
seven per cent increased risk of heart failure directly linked to that medication or strategy.
"The results of this study could prove to be the catalyst for how diabetes patients at risk for heart disease are managed moving forward," says Dr. Barry Rubin, Medical Director, Peter Munk Cardiac Centre, University Health Network (UHN). "As the number one global killer, and the second leading cause of death in Canada, the growing burden of heart disease is in many respects impacting patients, families and the healthcare system in ways that are unsustainable. Whatever proactive steps we can take to lessen the risk for development of the disease as illuminated in studies like this one, will yield far-reaching benefits in the future," he says.
The study reviewed and analyzed data from 14 trials involving 95,502 patients. Four per cent of patients suffered a heart failure event while being followed in the individual trials, while 9.8 per cent of patients in the study endured a major adverse cardiovascular event.
The relative increase in the risk of heart failure outweighed a five per cent reduction in heart attacks. The numbers show that for about every 200 patients treated, one additional hospital admission for heart failure was seen after an average of four years of follow-up.
Heart failure is a common occurrence for patients with type 2 diabetes and has a major impact on one's life expectancy and quality of life as well as representing a major driver of healthcare costs.
Video interview with Dr. Jacob Udell.
Women's College Hospital (www.womenscollegehospital.ca) is advancing the health of women and improving healthcare options for all by delivering innovative models of ambulatory care. Fully affiliated with the University of Toronto, the hospital is Canada's leading academic, ambulatory hospital and a world leader in women's health. With more than 800 physicians, nurses and health professionals, the hospital offers a range of specialized clinics and programs that are bridging the gaps in the health system. Women's College Hospital is helping to keep people out of hospital by being at the forefront of cutting-edge research, diagnosis and treatment that will help prevent illness and enable patients to manage their health conditions. This healthcare enables Canadians to live healthier, more independent lives. At the Women's College Research Institute, scientists combine science and patient care to develop innovative solutions to today's greatest health challenges.
The Peter Munk Cardiac Centre is the premier cardiac centre in Canada. Since it opened in 1997, the Centre has saved and improved the lives of cardiac and vascular patients from around the world. Each year, approximately 55,000 patients receive innovative and compassionate care from multidisciplinary teams in the Peter Munk Cardiac Centre, and the Centre trains more cardiologists, cardiovascular surgeons and vascular surgeons than any other hospital in Canada. The Centre is based at the Toronto General Hospital and the Toronto Western Hospital - members of University Health Network. www.petermunkcardiaccentre.ca
Phone: 416 340 4636