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School and Program Updates

Vanderbilt: Diabetes Drug Study Explores Cardiovascular Risks for Patients with Kidney Disease

Over the years there has been uncertainty over which drugs are best for patients with Type 2 diabetes and one of its common complications, kidney disease. An observational study using medical record information from nearly 50,000 U.S. military veterans sheds new light on this issue.

Among the 30 million U.S. adults with Type 2 diabetes, 20 percent have impaired kidney function. In patients like this, metformin, the recommended first-line drug therapy for Type 2 diabetes, is associated in the new study with 20 percent decreased risk of major adverse cardiovascular events when compared to a class of common diabetes drugs called sulfonylureas.

The study by researchers at Vanderbilt University Medical Center (VUMC) appears in JAMA, the flagship journal of the American Medical Association (AMA).

“The effectiveness of metformin demonstrated in this study will further support a potential change in prescribing practices for these patients. We believe these results should encourage providers to continue use of metformin in mild-to- moderate kidney disease,” said a leader of the study, Dr. Christianne Roumie, associate professor of Medicine and Pediatrics at VUMC.

The new study is focused on 24,679 patients who continued on metformin and 24,799 who continued on a sulfonylurea. To account for other factors that might influence cardiovascular risk, Dr. Roumie and colleagues evaluated patient characteristics like age, sex, race, other illnesses, body mass index and blood pressure.

Dr. Roumie was joined in the study by VUMC researchers from medicine, biostatistics and health policy. The study was supported by the Department of Veterans Affairs and the National Institutes of Health (DK092986).

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