CV Risk Lower With Metformin in T2DM + Reduced Kidney Function

According to a study published online Sept. 19 in the Journal of the American Medical Association to coincide with the annual meeting of the European Association for the Study of Diabetes, treatment with metformin versus sulfonylureas is associated with a reduced risk for major adverse cardiovascular events (MACE) among patients with type 2 diabetes and reduced kidney function.

Christianne L. Roumie, M.D., M.P.H., from the Veteran Administration Tennessee Valley VA Health Care System Geriatric Research Education Clinical Center in Nashville, Tennessee, and colleagues conducted a retrospective cohort study of U.S. veterans to compare MACE among patients with diabetes and reduced kidney function. The weighted cohort included 24,679 metformin users and 24,799 sulfonylurea users with a median estimated glomerular filtration rate of 55.8 mL/min/1.73 m² and hemoglobin A1c of 6.6 percent.

The researchers identified 1,048 MACE outcomes among metformin users and 1,394 events among sulfonylurea users (23.0 and 29.2 per 1,000 person-years, respectively) during follow-up (1.0 and 1.2 years, respectively). For metformin versus a sulfonylurea, the cause-specific adjusted hazard ratio for MACE was 0.80, yielding an adjusted rate difference of 5.8 fewer events per 1,000 person-years for metformin versus sulfonylurea use.

"This study and the results add to the limited observational evidence for the beneficial association of metformin compared with sulfonylurea and cardiovascular outcomes among those who develop reduced kidney function," the authors write.

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