A study conducted by a Summa Western Reserve Hospital physician along with Cleveland Clinic researchers suggests one of four commonly prescribed, inexpensive oral medications to treat diabetes might be safer for patients.
Dr. Kevin M. Pantalone, an endocrinologist at Summa Western Reserve Hospital in Cuyahoga Falls, and Cleveland Clinic researchers found patients who took one of three medications in a class known as sulfonylureas for type 2 diabetes had a greater than 50 percent increase in mortality risk compared with those who took metformin.
The retrospective study involved a review of the health records of more than 23,000 Cleveland Clinic patients with type 2 diabetes who took metformin or one of three sulfonylureas: glipizide, glyburide or glimepiride.
“These drugs are all available for free or $4 or less at local pharmacies,” Pantalone said. “Physicians and patients need to be aware of the adverse outcomes and side effects that are associated with all medications, including those that are free or cheap.
“ … No medication is without risk. This is something that we found that requires further study.”
The findings were recently presented at the Endocrine Society’s annual national meeting.
Sulfonylureas work by stimulating insulin secretion by the pancreas to help control blood sugar.
Among patients with coronary artery disease, only glimepiride didn’t have an increased mortality risk compared with metformin, Pantalone said. Those findings suggest glimepiride might be the safer choice for diabetic patients with coronary artery disease who can’t take metformin.
“The take-home point of this article is that it should prompt physicians and patients alike to review their therapies and to consider their overall health when considering what may be the best therapies for them,” Pantalone said. “We don’t want panic and people just stopping their therapies. Patients need to talk with their physicians about what might be the best, safest drug for them.”
Summa program
A collaboration among Summa Health System and hundreds of area doctors has been selected to participate in a new Medicare program designed to save money while improving patients’ health.
The U.S. Centers for Medicare and Medicaid Services announced the NewHealth Collaborative in Akron was among 89 programs known as accountable care organizations (ACOs) selected to participate in a new “shared savings” program.
Participating ACOs have agreements with the federal government to better coordinate care for Medicare patients. In exchange, the doctors and hospitals get a share of any resulting savings the Medicare program achieves, said Dr. Rodney Ison, chairman of the NewHealth Collaborative.
The NewHealth Collaborative brings together Summa’s Akron City, Barberton, St. Thomas, Wadsworth-Rittman and Western Reserve hospitals, affiliate Robinson Memorial Hospital and about 450 area physicians.
“In the end, what we’re doing now is not sustainable,” Ison said. “We’ve got to figure out a different way to take care of our community.”
An estimated 25,000 patients of participating doctors who are covered by traditional Medicare will receive letters notifying them that they can be part of the program, according to Ison.
The program should be seamless for patients, who will benefit from behind-the-scenes efforts to track when they need screenings and tests, Ison said. Services also will be developed to care for patients with complex chronic conditions.
About 12,000 area seniors who are covered by SummaCare’s Medicare managed-care plans already participate in the accountable care organization, Ison said.
About 7,000 Summa employees also are covered by the ACO program.
Cheryl Powell can be reached at 330-996-3902 or cpowell@thebeaconjournal.com. Follow Powell on Twitter at twitter.com/abjcherylpowell.
