Comment on: Evans JMM, Ogston SA, Emslie-Smith A, Morris AD (2006) Risk of mortality and adverse cardiovascular outcomes in type 2 diabetes: a comparison of patients treated with sulfonylureas and metformin. Diabetologia 49:930–936

Comment on: Evans JMM, Ogston SA, Emslie-Smith A, Morris AD (2006) Risk of mortality and adverse cardiovascular outcomes in type 2 diabetes: a comparison of patients treated with sulfonylureas and metformin. Diabetologia 49:930–936

“…The same group of investigators demonstrated in another two studies [5,6] using the same database that, compared with sulfonylurea monotherapy, the combination of sulfonylurea and metformin is associated with a reduced risk of mortality. These findings are in contrast to those reported by Olsson and co-workers [7], also referred to by Tayek in his letter [1]. Although Olsson and colleagues reported that mortality was increased in diabetic patients given a combination of sulfonylurea and metformin compared with those patients given sulfonylurea alone, this study involved far fewer patients than the study by Johnson et al [6].…”

“…A. Tayek describes studies that demonstrate an increased risk of mortality in type 2 diabetic patients treated with sulfonylureas [1]. He rightly highlights that Evans et al [2] demonstrated an increase in cardiovascular mortality with sulfonylurea monotherapy compared with metformin monotherapy.…”

Response to comment on: Evans JMM, Ogston SA, Emslie-Smith A, Morris AD (2006) Risk of mortality and adverse cardiovascular outcomes in type 2 diabetes: a comparison of patients treated with sulphonylureas and metformin. Diabetologia 49:930–936

“…A. Tayek [2], that have identified increased cardiovascular mortality among type 2 diabetic patients treated with sulphonylureas compared with patients prescribed other therapies (such as metformin). He argues that prospective, randomised clinical trials are necessary to establish whether sulphonylureas are linked with excess mortality.…”