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Glitazones risk warning

New research has concluded that glitazones increase the risk of heart failure by 70 per cent in type 2 diabetes.

The retrospective cohort study involving 33,544 US patients found that even after adjusting for differences between the two patient groups, the incidence of heart failure after 40 months was 8.2 per cent in patients treated with glitazones compared with 5.3 per cent in controls. The results were published in Diabetes Care (November) and highlighted on the NHS Medicines Information website.

Dr Peter Stott, a GP in Tadworth, Surrey, and a board member of the National Obesity Forum, said: 'A 70 per cent increase sounds very dramatic. It is certainly more than was thought and is worthy of follow-up in a more rigorous prospective study. But it is still only an extra three people in every 100.'

Dr Stott said it remained his view that GPs should prescribe glitazones more often and not restrict their use to patients unable to take combination metformin-sulphonylur-ea, as recommended by the National Institute for Clinical Excellence.

Dr Peter Tasker, a GP in Kings Lynn, Norfolk, and former head of Primary Care Diabetes UK, said: 'It is still a relatively small risk. We are sup- posed to be checking for liver disease anyway so now the surveillance as well as being hepatic has to also be cardiovascular.'

 · Glitazones update, page 54

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