Diabetes Medication Can Help Heart Health

The type of medicine matters when it comes to heart health among diabetics.
A new study has found evidence that medications that lower blood sugar levels can slow the progression of a condition that can lead to heart attacks.
Known as the PERISCOPE trial, the study looked at 543 patients with coronary disease and type 2 diabetes to see how insulin producing drugs compared with insulin providing drugs in combating coronary atherosclerosis, a build up of fat deposits in the artery walls that can lead to stroke or heart attack.
Dr. Steven E. Nissen of the Department of Cardiovascular Medicine at Cleveland Clinic Foundation was the lead author of the study, which was published in the April 2 issue of the Journal of the American Medical Association.
The research demonstrates for the first time the ability of a blood sugar lowering medication to slow the artery buildup in patients with diabetes. Cardiovascular diseases are the cause of death in approximately 75 percent of patients with diabetes.
Patients with diabetes often take oral medications to lower their blood sugar levels. There are two main types of drugs that function quite differently. One type of drug simulates insulin secretion, known as secretagogues. The other type of drug reduces insulin resistance, known as insulin sensitizers.
The research compared the effects of pioglitazone, a type of insulin sensitizer, with that of glimepiride, an insulin secreting drug, on the progression of the artery wall fat buildup in patients with Type 2 diabetes.
Treatment with the insulin sensitizer resulted in a lower rate of progression of coronary atherosclerosis compared with the insulin secreting drug in patients with type 2 diabetes and coronary artery disease, the study authors conclude.
The 543 patients with coronary disease and type 2 diabetes, who participated in the double-blind, randomized trial at 97 hospitals in North and South America, received the insulin secreting drug for 18 months.
To be eligible, patients had to be age 35 to 85 with a HbA1c, measure of blood sugar, level between 6.0% and 9.0%, if taking a blood sugar lowering medication or a 6.5% to 10% if not on medication. Patients were excluded if they had uncontrolled high blood pressure or liver disease. Participants were tested beforehand to make sure less than half of their arteries were blocked.
In addition to slowing the progression of coronary atherosclerosis, participants registered cholesterol and blood pressure levels below the target guidelines for patients with diabetes.

Source: Nissen et al., “Comparison of Pioglitazone vs. Glimepiride on Progression of Coronary Atherosclerosis in Patients with Type 2 Diabetes.” April 2, 2008 Journal of American Medical Association.