Metformin vs sulfonylurea? July 19, 2018

During an average follow-up period of just over a year, sulfonylurea use (switching and adding combined) was associated with an increased risk of heart attack (7.8 v 6.2 per 1000 person years), all cause mortality (27.3 v 21.5), and severe hypoglycaemia (5.5 v 0.7), compared with continuing metformin alone.
 https://www.sciencedaily.com/releases/2018/07/180718183602.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fhealth_medicine%2Fdiabetes+%28Diabetes+News+--+ScienceDaily%29

Metformin vs  sulfonylurea? There is the problem. SU added - on as second line in treatment, why? Because of first line, metformin, did not work. Now it is study to suggest, because of Metformin alone does not work, it is better to ... , it is better to do what? Add - on SU. But at the same time Metformin must stay in treatment regime. Why? If Metformin did not work in first place then why it must stay now? How study find it? Simple. Metformin must stay. Period. Then add-on SU. Together they work better. Poison from Metformin + Beta Cells destruction from SU + Low Blood sugar from SU all together they will kill better then any one of these drags alone.
  
It is really interesting. Just withing one year increased risk of all cause mortality. Take study a little bit longer, and withing less then 10 years all participants would be in death.

To compare, study what would happen if in stead add-on SU, it will be Insulin added as first line therapy? How diabetics type 2 would survive? Just one year, and result will be dramatic. All complications will be vanished. And what about benefits of this therapy? Diabetics type 2 no longer occupy medical clinic. There are no bills to be paid. There are no diet docors to publish books and articles how to eat. Diabetics type 2 as every one else can eat as they please. And do not pretend that they eat cake every day biggest one and as ass-on take three tops of pizza every meal.  Not at all. Diabetics type 2 not monsters. They are intelligent and well educated. At least, no one of them is enemy to themselves.

As such, they conclude that sulfonylureas as second line drugs "are associated with an increased risk of myocardial infarction, all cause mortality, and severe hypoglycaemia, compared with remaining on metformin monotherapy."

via Ravenvoron