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Cited by 421Diabetes Treatment and ManagementMetabolism, Diabetes, and CancerDiabetes Management and Research

Decreased Mortality Associated With the Use of Metformin Compared With Sulfonylurea Monotherapy in Type 2 Diabetes

Johnson, Jeffrey A., Majumdar, Sumit R., Simpson, Scot H., Toth, Ellen L.·2002·Diabetes Care
DOI 10.2337/diacare.25.12.2244
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Abstract

OBJECTIVE—The aim of this study was to examine the relationship between use of metformin and sulfonylurea and mortality in new users of these agents. RESEARCH DESIGN AND METHODS—Saskatchewan Health databases were used to examine population-based mortality rates for new users of oral antidiabetic agents. Individuals with prescriptions for sulfonylurea or metformin in 1991–1996 and no use in the year prior were identified as new users. Prescription records were prospectively followed for 1–9 years; subjects with any insulin use were excluded. Causes of death were identified based on ICD-9 codes in an electronic vital statistics database. Multivariate logistic regression and survival analyses were used to assess the differences in mortality between drug cohorts, after adjusting for potential confounding variables. RESULTS—The total study sample comprised 12,272 new users of oral antidiabetic agents; the average length of follow-up was 5.1 (SD 2.2) years. In subjects with at least 1 year of drug exposure and no insulin use, mortality rates were 750/3,033 (24.7%) for those receiving sulfonylurea monotherapy, 159/1,150 (13.8%) for those receiving metformin monotherapy, and 635/4,683 (13.6%) for those receiving combination therapy over an average 5.1 (SD 2.2) years of follow-up. The adjusted odds ratio (OR) for all-cause mortality for metformin monotherapy was 0.60 (95% CI 0.49–0.74) compared with sulfonylurea monotherapy. Sulfonylurea plus metformin combination therapy was also associated with reduced all-cause mortality (OR 0.66, 95% CI 0.58–0.75). Reduced cardiovascular-related mortality rates were also observed in metformin users compared with sulfonylurea monotherapy users. CONCLUSIONS—Metformin therapy, alone or in combination with sulfonylurea, was associated with reduced all-cause and cardiovascular mortality compared with sulfonylurea monotherapy among new users of these agents.

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Crossref · 10.2337/diacare.25.12.2244

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  • Metformin and sulfonylurea combination therapy was associated with reduced all-cause mortality.

    “Metformin and sulfonylurea combination therapy was also associated with reduced all-cause mortality [26].”

    From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [26]

  • Metformin use was associated with reduced all-cause mortality and reduced cardiovascular mortality.

    “The use of metformin was associated with reduced all-cause mortality and reduced cardiovascular mortality.”

    From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [26]

  • A retrospective analysis of Saskatchewan databases reported significant reductions for all-cause mortality and cardiovascular mortality of 40% and 36%, respectively.

    “A retrospective analysis of patients databases in Saskatchewan, Canada reported significant reductions for all-cause mortality and cardiovascular mortality of 40% and 36%, respectively [26].”

    From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [26]

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Authors
Johnson, J. A., Majumdar, S. R., Simpson, S. H., & Toth, E. L.
Affiliations
  • University of Alberta (CA)
  • Institute of Health Economics (CA)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2002-12-01
Volume
25
Issue
12
Pages
2244-2248
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.25.12.2244
OpenAlex
W2107166617
Cited by
421
References
29
Citations by year
2026: 4 · 2025: 5 · 2024: 2 · 2023: 7 · 2022: 13 · 2021: 11 · 2020: 14 · 2019: 13 · 2018: 16 · 2017: 19 · 2016: 15 · 2015: 27 · 2014: 23 · 2013: 25 · 2012: 22
FWCI
11.02
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
metformin, sulfonylureas, type 2 diabetes, all-cause mortality, cardiovascular mortality, oral antidiabetic drugs, combination therapy, new users, drug safety
MeSH terms
Aged, Cause of Death, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Hypoglycemic Agents, Male, Metformin, Middle Aged, Saskatchewan, Sulfonylurea Compounds, Time Factors, Cohort Studies, Databases, Factual

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