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Cardiovascular disease is responsible for 75% of deaths in patients with diabetes, but whether blood sugar control itself lowers this risk is unclear. Researchers addressed that issue in what is purportedly the first head-to-head comparison of a sulfonylurea (an insulin secretagogue) and a thiazolidinedione (an insulin sensitizer); 543 diabetic adults (age range, 35–85) with known coronary artery disease and glycosylated hemoglobin (HbA1c) levels <10% were randomized to daily therapy with the sulfonylurea glimepiride or the thiazolidinedione pioglitazone (Actos). The maker of pioglitazone funded the multicenter study, and its employees were on the research team.
Most patients were taking standard preventive therapies (e.g., aspirin, statins)…