The rate of heart failure increased by 48% for patients who did not receive a sulfonylurea when the LVFR was 40% or less.
Metformin can replace or delay the type 2 glucose transporter inhibitor.
Start treatment with metformin In patients with Type 2 diabetes Shortly after hospitalization heart failure It was associated with a lower frequency of hospitalization for heart failure Over the next year, when left ventricular ejection fraction were greater than 40%.
In the study when a sulfonylurea Instead, the rate of occurrence of recurrence heart failure He was neutral when he was left ventricular ejection fraction were greater than 40%. but average heart failure increased by 48% for patients who did not receive a sulfonylurea When the index left ventricular ejection fraction It was 40% or less.
These findings are “provocative,” but because they came from an observational study, they “generate hypotheses rather than definitively,” Stephen J. GreenAnd MD , lead author of the study.
“To change the practice with metformin For patients with heart failure s diabeticWe need a randomized controlled trial to definitively test cause and effects.” GreenAnd Cardiologist at Duke University in DurhamAnd North Carolina.
For experts it is better to avoid a sulfonylurea “However, regarding sulfonylureaThese findings, and those of other observational studies, showed a sign of damage heart failure. with many others Oral treatments for diabetes To choose with very positive or neutral effects on results heart failure In randomized trials “I think it is best to avoid it sulfonylurea treatment In these patients, if possible” Green in an interview.
Existing evidence “indicates that agents in class 2 sodium-glucose transporter inhibitors (NGT)SGLT2) is the first choice as an oral hypoglycemic agent for these patients, and metformin “It is a consideration if additional glucose reduction is needed,” he added.
Other experts agree with the study’s conclusions:
“General conclusions that metformin It was associated with no harm or benefit consistent with current recommendations for preferential use metformin and inhibitors SGLT2 In patients with diabetic e heart failurecommented Alice Wai ChingAnd MD And University endocrinologist. from torontoAnd OntarioAnd Canada.
“There were only 193 people infected with left ventricular ejection fraction 40% or less in a group metforminSo I would be very careful when drawing conclusions from this data,” agreeing that the results generate hypotheses.
He also indicated that the report did not address patients who were not hospitalized heart failure, “So it does not contribute to the discussion about the use of metforminIn patients without a history of repeated hospitalizations for heart failure.
the metformin Can replace or delay a SGLT2 inhibitor “Inhibitors SGLT2 It should be part of the treatment regimen for patients with heart failure from which type. This report also supports the use of metformin in the People Type 2 diabetes e heart failure, but not in place SGLT2 inhibitor or to delay the start of a file SGLT2 Cheng said in an interview.
Darren K. McGuire, MDThe cardiologist and professor at UT Southwestern Medical Center, based in Dallas, urged caution when considering the results of this study.
Consultation source here.