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The research is quite clear – oral medications to treat type 2 diabetes do not alter the long-term progression of the disease. While these drugs can be quite effective in the short term, several different types are associated with increased all cause mortality and in particular an increased risk for dying due to cardiovascular disease.
In addition, often the type 2 diabetic fails to make necessary lifestyle and dietary changes to improve/reverse their condition because these drugs also create a false sense of security. Ultimately all of these drugs lose their effectiveness over time and start a viscous cycle where they are prescribed at higher dosages or in combination with other drugs, all of which leads to an even greater rate of mortality. In fact, the long-term use of some of these drugs is actually associated with an earlier death compared to control groups with type 2 diabetes not being given the drugs.
The most widely prescribed drug for type 2 diabetes is metformin (Glucophage). While studies have shown that metformin alone has illustrated a decrease in heart attacks and all diabetes related deaths compared with other drugs, it does not work at all in about 25 percent of cases and tends to lose its effectiveness with time. When the latter happens it is usually combined with a sulfonylurea, which actually increases mortality risk.
On their own, these sulfonylureas drugs are of limited value and there is some evidence to indicate that sulfonylureas actually produce harmful long-term side-effects. For example, in a famous study conducted by the University Group Diabetes Program (UDGP), it was shown that the rate of death due to a heart attack or stroke was 2.5 times greater in the group taking tolbutamide (a sulfonylurea), than the group controlling their type 2 diabetes by diet alone.
Though newer sulfonylureas are promoted as being safer than tolbutamide, new data calls into that widely held belief into question.
Examples of sulfonylureas:
- acetohexamide (Dymelor)
- chlorpropamide (Diabinese, Insulase)
- glimepiride (Amaryl)
- glipizide (Glipizide, Glucotrol)
- glyburide (Diabeta, Micronase)
- repaglinide (Prandin)
Another class of oral diabetes drugs that appear to increase risk of mortality are the thiazolidinediones such as pioglitazone (Actose) and rosglitazone (Avandia). The first drug in this class, Rezulin (troglitazone), was removed from the market because widespread deaths occurred due to liver failure. Now pooled results from 42 different studies with Avandia showed there was a 43 percent increase in the number of heart attacks and a 64 percent increased risk of dying from heart disease compared to people with type 2 diabetes given a placebo. In addition, both Actose and Avandia are also associated with significant weight gain. While these drugs may have some benefits in lowering blood sugar levels, it is clear that the side effects outweigh these benefits.