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Older, less expensive drugs as effective for type 2 diabetes
Older, less expensive drugs as effective for type 2 diabetes

July 19, 2007 (Insidermedicine) A review of  over 200 clinical trials and other studies by researchers from Johns Hopkins University has found evidence that older and less expensive oral medications are as effective at controlling type 2 diabetes as newer compounds. Indeed, a compound called metformin, which was discovered in the 1920s and which has been used for the treatment of diabetes for a half-century, appears to offer the biggest benefits with the lowest risk. 

The results of this in-depth survey of existing data comes following the publication of another look at published studies, which indicated that treatment of type 2 diabetes with a newer drug called rosiglitazone might increase a person's risk of heart problems. 

The latest study was undertaken to help clinicians and physicians get a better handle on the benfits and risks of the many drugs used to treat type 2 diabetes.  

The Johns Hopkins researchers identified over 200 sources of data on the diabetes drugs including original research articles, reviews of the literature, unpublished data from the United States Food and Drug Administration, and data from manufacturers. Some, like metformin, have been in use for awhile. Others are more recent oral medications. The study did not look at the latest class of anti-diabetes compounds known as incretin mimetics, since information on these drugs is still fairly scanty. 

The effects of the drugs on cholesterol levels – both the "good" artery-clearing variety and the "bad" artery clogging version – were compared, as were the compounds' influence to blood pressure and weight gain. 

The finding that the tried-and true medications are still a great option backs up the recommendations issued jointly in 2006 by the American Diabetes Association  and the European Association for the Study of Diabetes. 

The latest results add weight to the view that use of the more established diabetes medications first is a wise strategy. If these are not effective, the newer medications can be tried before resorting to the use of insulin. 

Reporting for Insidermedicine, I’m Dr. Susan Sharma.