December 2, 2009

expert reaction to research on type 2 diabetes and cardiovascular disease, as published in the BMJ

The study found evidence suggesting a link the use of a commonly-used diabetes drug and increased risk of heart failure.

Prof Corinne de Vries, Professor of Pharmacy & Pharmacology at the University of Bath, said:

“The study is interesting, although the investigators appear to have estimated the risks associated with the exposure at the time of the event, i.e. at the time of death, heart failure, AMI, etc. This will have lead to spuriously favourable results for pioglitazone and rosiglitazone, because these are prescribed to people at a lower risk of heart failure than the general population with diabetes.

“Similarly, the unfavourable results for sulfonylureas compared with metformin are difficult to interpret as a result of this approach. Whilst the investigators have attempted to make statistical adjustments for any confounders, there is a fundamental problem with using exposure at the time of the event as the relevant exposure, and in my view a different study design would have been more appropriate.”