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Observational study
Metformin associated with better cardiovascular outcomes than other glycaemic therapies
  1. Zachary T Bloomgarden
  1. Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA
  1. Correspondence to : Dr Zachary T Bloomgarden, Department of Medicine, Mount Sinai School of Medicine, 35 East 85th Street, New York, NY 10028, USA; zbloom{at}

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A question exists as to whether the outcome of glycaemic treatment of diabetes varies with the agent used; speculation surrounds whether metformin might be preferable to other treatments.


Ghotbi and colleagues performed an epidemiological analysis of 8192 obese patients with diabetes at increased cardiovascular risk participating in the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Mortality and a combined cardiovascular outcome of non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest or cardiovascular death were compared among those receiving one of the following interventions: no pharmacological glycaemic treatment, metformin monotherapy, insulin monotherapy, sulfonylurea monotherapy, metformin plus sulfonylurea and metformin plus insulin. Each group consisted of approximately 1000–1500 participants, randomised to either sibutramine or control (the main purpose of the trial) and followed up to 6 years. The authors performed …

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  • Competing interests None.