Sulfonylureas Increasing Lipids for Type 2 Diabetes Patients?

In the study, sulfonylureas correlated with a significant increase in levels of free fatty acids….

According to a meta-analysis published in the Journal of Evidence-Based Medicine, “It is known that sulfonylureas may increase levels of triglycerides, free fatty acids, and lower HDL and LDL.” Yue-hong Chen and her colleagues from Sichuan University in China conducted a literature review to examine sulfonylureas on lipid levels in type 2 diabetes patients. The data was included from 52 randomized controlled trials.

The results indicated that sulfonylureas correlated with a significant increase in free fatty acids (standardized mean difference=0.24) and triglycerides (MD=0.06), and correlated with decreases in HDL and LDL cholesterol (MD=–0.07 and –0.11, respectively). Also, the sulfonylureas had no effect on apolipoprotein AL, apolipoprotein B, and total cholesterol (MD=0.01, -0.01, 0.01). Compared to metformin, sulfonylureas increased total cholesterol and LDL. However, compared with glinides, sulfonylureas lowered HDL, LDL, and triglycerides.

The researchers concluded that sulfonylureas have a small effect on lipids “although they may statistically increase the level of free fatty acids and triglycerides, and decrease LDL and HDL cholesterol.”

Practice Pearls:

• Compared to other antidiabetic medications, sulfonylureas increased total cholesterol, LDL, triglycerides, and lowered HDL.
• From the study, the results showed that sulfonylureas correlated with a significant increase in levels of free fatty acids.
• Sulfonylureas may affect patients with type 2 diabetes who have hyperlipidemia.

Chen, Yue-hong. “Sulfonylureas May Affect Lipids in Type 2 Diabetes.” J Evid Based Med. 2015;doi:10.1111/jebm.12157.11 June 2015.