Science Daily — Compared to another popular drug, three widely used diabetes medications are associated with a greater risk of death, a large new analysis finds. The results were presented June 25 at The Endocrine Society's 94th Annual Meeting in Houston.
"We have clearly demonstrated that metformin is associated with a substantial reduction in mortality risk, and, thus, should be the preferred first-line agent, if one has a choice between metformin and a sulfonylurea," said study lead author Kevin M. Pantalone, D.O., an endocrinologist at Summa Western Reserve Hospital in Cuyahoga Falls, OH, who conducted this study in conjunction with a team of researchers from Cleveland Clinic in Cleveland, OH.The drugs, glipizide, glyburide, and glimepiride, are known as sulfonylureas, which help decrease blood-sugar levels among type 2 diabetes patients by stimulating the pancreas to produce insulin. In the past, these medications were considered comparable to one another in terms of effectiveness and safety. Recently, however, research has shown some sulfonylureas may be safer than others. These findings led to this latest research, which compared them to another type of blood-sugar-reducing drug known as metformin. All four medications are available under low-cost, generic labels.
In the United States, nearly 26 million people, or 8 percent of the population, have diabetes, according to the Centers for Disease Control and Prevention. Many of these patients also have other underlying medical conditions, including heart, or coronary artery, disease.
Investigators found that all three sulfonylureas studied were associated with a more than 50 percent greater risk of death compared to metformin. Additionally, among diabetes patients with heart disease, only glimepiride did not increase the risk of death compared to metformin. In contrast, glipizide was associated with a 41 percent, and glyburide with a 38 percent greater risk.
"Since many patients with type 2 diabetes also have coronary artery disease, our results could potentially impact the care of a large number of patients," Pantalone said. "In these patients, we now know that glimepiride appears to be safer than the other commonly prescribed sulfonylureas, glipizide and glyburide, available in the United States."
For this retrospective study, using the electronic health-record system at Cleveland Clinic, the investigators identified 23,915 patients with type 2 diabetes who previously had received treatment with one of the four medications. Overall, the study population's average age (years) was 62, and 50 percent were male. Among the subgroup with heart disease, the average age was 68, and 69 percent were male. Both groups comprised primarily Caucasian patients. The median follow-up was slightly more than two years.
According to Pantalone, this research serves as a reminder that adverse events can occur with any medication. "All drugs have risks, even those which are generic and relatively inexpensive," he said. "It is important to talk to with your doctors about which drugs may be better and safer options, which may vary depending on your other health conditions."
In addition to the data from the hospital electronic health-record system, investigators analyzed death statistics from the Social Security Death Index. The study was supported through a grant from Astra Zeneca.
துளசியின் மருத்துவ குணங்கள் ஏராளம், அதற்கு ஆன்மீக மகத்துவமும் உள்ளதாக புராணங்கள் கூறுகின்றன.
“Everyone is engaged in material sense gratification, but people have no plan for making an ultimate solution to their real problems, namely, birth, disease, old age and death. These four material miseries are called bhava-roga, or material diseases. They can be cured only by Krishna consciousness. Therefore Krishna consciousness is the greatest benediction for human society.” (Shrila Prabhupada, Chaitanya Charitamrita, Adi 3.97 Purport)
Bhakti-yoga reaches into the depths of the soul and extracts the true potential for action. Within that enlivened state, the ancillary concerns are accounted for automatically. To use the previous example again, with an identified objective of a fit body, I automatically tweak my daily routine. I may or may not know how to eat properly in the beginning, but with trial and error and an evaluation of the results with respect to the final goal, I can decide which procedures work and which ones don’t.
We must also incorporate the fact that the life of hedonism is not appealing to someone who knows the nature of the soul and how to connect with the reservoir of pleasure. From this fact alone we get a limitation to the atheist’s motto of “do whatever you want, whenever you want.” But when you flip things around, you see that bhakti-yoga brings happiness even to the atheist, in spite of their initial reluctance to practice it.
For the serious yogi in bhakti, the chanting routine is extended to a fixed minimum number of daily recitations of the maha-mantra on a set of japa beads. There is also a prohibition on meat eating, gambling, intoxication and illicit sex. What is considered bitter in the beginning turns into sweet nectar, whereas with sense gratification in ignorance the situation is reversed. The person in bhakti feels the pleasure of connecting with God, which in turn makes them more anxious to continue that service going forward. The person who despises God or ignores His existence at least with bhakti finds a peaceful routine and a way to steer clear of activities that are so harmful. In this way both sets of participants benefit. As the devotee and staunch atheist represent the extreme opposite ends of the spectrum, every type of condition in between is accounted for as well.
