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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Endocrine Disorders 1/2015

Reduced vascular events in type 2 diabetes by biguanide relative to sulfonylurea: study in a Japanese Hospital Database

BMC Endocrine Disorders > Ausgabe 1/2015
Makito Tanabe, Takashi Nomiyama, Ryoko Motonaga, Kunitaka Murase, Toshihiko Yanase
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12902-015-0045-y) contains supplementary material, which is available to authorized users.

Competing interests

RM and KM have no competing interests. MT, TN and TY have received speaker fees or chairman fees from MSD K.K., Sanofi K.K., Takeda Pharmaceutical Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Sanwa Chemistry Co., Ltd., Eli Lilly Japan K.K., Novo Nordisk Pharma Ltd., Daiichi Sankyo Co., Ltd., Novartis Pharma K.K., and Astellas Pharma Inc. TY was supported financially in his research by MSD K.K., Sanofi K.K., Takeda Pharmaceutical Co., Ltd., Daiichi Sankyo Company Ltd., Dainippon Sumitomo Pharma Co., Ltd., Sanwa Chemistry Co., Ltd., Eli Lilly Japan K.K., Novo Nordisk Pharma Ltd., Novartis Pharma K.K., Kowa Co. Ltd., and Fujifilm Pharma Co., Ltd. The Department of Bioregulatory Science of Life-related Diseases of Fukuoka University (Fukuoka, Japan) was supported financially by a donation from MSD K.K.

Authors' contributions

MT carried out the data arrangement and drafted the manuscript. TN and TY conceived the study, participated in its design and coordination, carried out data arrangement, and helped to draft the manuscript. RM and KM reviewed and edited the manuscript. All authors read and approved the final version of the manuscript.

Authors' information

Not applicable.



Some oral hypoglycemic agents (OHAs) have been suggested to reduce the risk of cardiovascular disease (CVD) in type-2 diabetes mellitus (T2DM). We ascertained if OHAs affect CVD risk in a cohort analysis of a multicenter medical-cost accounting database in Japan.


Data of 4095 and 1273 T2DM patients in study 1 and study 2, respectively, were extracted from the database based on the following conditions: (i) began treatment with a single OHA (sulfonylurea, biguanide, thiazolidinedione, α-glucosidase inhibitor, glinide, or dipeptidyl peptidase-4 inhibitor) and continued the medication for ~1–1.4 years; (ii) hemoglobin (Hb)A1c level at baseline was available; (iii) age at baseline was 40–70 years; (iv) presence or absence of CVD history was not considered in study 1, but presence of CVD history was considered in study 2. Effects of OHAs relative to sulfonylurea on CVD risk according to ICD-10 were analysed using Kaplan-Meier curves during 104 weeks.


In study 1 targeting T2DM patients with and without a history of CVD, initial and baseline treatment with a biguanide significantly lowered the risk of CVD compared with that with a sulfonylurea, and was independent of HbA1c control. In study 2, a similar significant preventive effect of a biguanide on CVD risk relative to a sulfonylurea was observed in T2DM patients with history of CVD.


Initial treatment and baseline treatment with a biguanide can reduce CVD risk relative to a sulfonylurea independent of the blood glucose-lowering effect of the biguanide in Japanese T2DM patients.
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