Metformin linked to increased risk of acute dialysis in T2DM

[mannmade]

Home Diabetes August 23, 2016
Metformin linked to increased risk of acute dialysis in T2DM
August 23, 2016
Metformin linked to increased risk of acute dialysis in T2DM
(HealthDay)—For patients with type 2 diabetes, metformin is associated with about a 50 percent increase in the risk of acute dialysis compared to sulfonylureas, according to a study published online Aug. 18 in Diabetes, Obesity and Metabolism.


Nicholas Carlson, M.D., from Copenhagen University in Denmark, and colleagues conducted a retrospective nationwide cohort study involving 168,443 drug-naive patients with type 2 diabetes aged 50 years and older. Participants initiated treatment with metformin or sulfonylurea between 2000 and 2012 (70.7 percent initiated treatment with metformin).
The researchers found that the one-year risk for acute dialysis was 92.4 per 100,000 for sulfonylurea and 142.7 per 100,000 for metformin. The one-year risk of acute dialysis associated with metformin was increased by 50.3 per 100,000 (risk ratio, 1.53; number needed to harm, 1,988).
"In a retrospective nationwide cohort study on the risk of acute dialysis associated with initiation of metformin in patients with type 2 diabetes, treatment with metformin was associated with a 50 percent increase in risk of acute dialysis compared with sulfonylurea," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
Explore further: Sulfonylureas up cardio events versus metformin
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[peppy]

Diabetic type 2 standards. Metformin is used in mono-therapy, dual therapy and triple therapy.

It is inexpensive.

Alrighty then. Buyer beware.

So every type 2 gets to have their kidneys destroyed. Number 1 on the protocol.

Physicians unwilling to prescribe afrezza for lung worries, very willing to prescribe metformin and take out kidneys.

alrighty then

[mnholdem]

This is what bothers me. Studies I posted provide solid evidence (data from nearly 1,000 patients) that early intensive insulin therapy has resulted in nearly two years of drug free remission in nearly half the patients. The medical community has largely ignored studies like this. Pills are cheap = life is cheap.

[babaoriley]

Spiro has long preached to me the dangers of Metformin, as he calls it, "a very dangerous drug."

However, Afrezza has been linked rather conclusively to the loss of huge sums of money, so I ask, "which is worse?"

[agedhippie]

The increase came in elderly frail patients, these are people more likely to develop AKI with or without drugs. They also give a laundry list of factors they did not remove which they say could invalidate the result:

Notably, information relating treatment indication was unavailable, whereby interpretations of results are subject to bias due to confounding-by-indication. Specifically,  information relating indication for acute dialysis was unknown. Additionally, the absence of  information regarding eGFRs in the whole population is inopportune, and residual confounding  secondary to alcohol and tobacco consumption, eGFR, obesity, proteinuria and compliance remains insufficiently addressed.

There is also an interesting comment that there is also evidence that metformin may protect the kidneys. The end conclusion is that you should not give metformin to elderly frail or seriously ill patients with poor kidney function which is not exactly earth shattering. That metformin patients have a lower rate of microvascular complications.