Metformin vs. Glipizide for Patients with Diabetes and Coronary Disease

Observational data have suggested that metformin, compared with sulfonylureas, protects patients with type 2 diabetes against adverse cardiovascular events. In this double-blind trial from China, researchers randomly assigned 304 diabetic patients with documented coronary artery disease to receive either metformin or glipizide for 3 years. At baseline, mean glycosylated hemoglobin (HbA_1c) was 7.6%; most patients were taking aspirin and statins. During the study, insulin was added in about 25% of patients in each group. After the formal 3-year randomized intervention, monitoring of patients continued, with average total follow-up of 5 years.

The primary outcome was a broad composite of nonfatal cardiovascular events and death from any cause. …