(HealthDay News) — For patients with type 2 diabetes, the risk for myocardial infarction (MI) or stroke is similar for treatment with insulin or sulfonylureas in combination with metformin, according to a study published in Diabetes, Obesity and Metabolism.

James S. Floyd, MD, from the University of Washington in Seattle, and colleagues conducted a population-based case-control study to examine the risks for MI and stroke associated with sulfonylureas and insulin used in combination with metformin. 

Cases had type 2 diabetes and used metformin plus insulin or sulfonylureas at the time of a first MI or stroke, while controls used the same treatment combinations and were sampled from the same population. Medical records were reviewed to validate MI and stroke diagnosis and potential confounders.

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The risk for MI or stroke was similar for metformin plus insulin and metformin plus sulfonylureas (OR=0.98; 95% CI, 0.63-1.52), according to the researchers. The precision of the estimate was improved on meta-analysis with another observational study (relative risk=0.92; 95% CI, 0.69-1.42).

“Current evidence suggests that there may not be large differences in cardiovascular risk associated with the use of insulin or sulfonylureas when used in combination with metformin,” the researchers wrote.

One author disclosed financial ties to Zoll LifeCor and Johnson & Johnson.


  1. Floyd JS et al. Diabetes Obes Metab. 2015;doi:10.1111/dom.12537.