Common Diabetes Medications Can Cause Heart Failure
Medications used to help diabetics manage their blood sugar could increase their risk for heart failure, according to research presented recently at the American College of Cardiology's Annual Scientific Session.
The study found that newer or more intensive drugs for blood sugar management were linked to a 14 percent overall increased risk for heart failure. Drugs in the peroxisome proliferator-activated receptors class, or PPAR agonists – like Actos or Avandia – were associated with the highest risk. Dipeptidyl peptidase-4 (DPP-4) inhibitors, like Januvia, were associated with intermediate risk of heart failure, while long-acting insulins like Lantus were associated with "neutral" risk.
"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," said Dr. Jacob Udell, lead study investigator.
Heart disease is still the number one cause of death globally, and it is also the primary cause of death among people with type 2 diabetes, according to the American Heart Association.
Weight management is key
A common side effect of many blood sugar lowering medications is weight gain, which could be the most dangerous outcome for patients taking these drugs: The study found that every 1 kilogram (about 2 pounds) of weight gain associated with taking a blood sugar medication was linked to a 7 percent increased risk of heart failure.
While blood sugar medications are a common first approach for patients with diabetes, other lifestyle interventions could help lessen risk for cardiovascular events, said senior author Dr. Michael Farkouh.
"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," Farkouh said.
The study is published in The Lancet Diabetes and Endocrinology.