Gliptin Drugs Raise Heart Failure Risks

| November 29, 2016

People with type 2 diabetes are at higher risk of congestive heart failure. So it is astonishing that some diabetes drugs are still prescribed when they are known to increase heart failure risk further – in some cases by as much as 42 per cent, as I reported here.

Congestive heart failure happens when the heart doesn’t beat strongly enough. This starves the body of oxygen and causes fluid to build up around the heart, a condition that can become fatal – it is a leading cause of death in people with diabetes.

But, tragically, heart failure has been largely overlooked in the safety testing of diabetes drugs. In 2008, the US Food and Drug Administration (FDA) issued guidance to the drug companies, requiring them to show that new drugs for type 2 diabetes do not increase the risk of cardiovascular disease. But there was a flaw in this guidance. It mentioned heart attack, stroke and cardiovascular death, but not heart failure.

Consequently, some diabetes drugs – especially the DPP4-inhibitors, or gliptins – were approved as being safe when they were anything but. The FDA gave the green light to one of these drugs, AstraZeneca’s saxagliptin (Onglyza), in 2009, based on the company’s minimal safety studies showing no cardiovascular risks. But they asked AstraZeneca to do more in-depth studies to verify its findings.

It was another four years before the results of these new studies were published. They showed Onglyza increased the risk of hospitalisation for heart failure by a whopping 27 per cent.1 The FDA leapt into action – after scratching their heads for five months, they asked to see AstraZeneca’s full trial data. They chewed that over for another two years, before finally issuing a warning in April 2016 about Onglyza’s heart failure risks – seven long years, and who knows how many unnecessary deaths, since the drug was first approved.

The FDA’s foot-dragging is deplorable. What is worse is the thought that AstraZeneca might have known about the heart failure risks of Onglyza at an early stage, but sat on the information for as long as possible, so as not to damage its sales.

In my next blog post I’ll tell you why the recent headline “How to prevent heart failure in type 2 diabetes” turned out to be a red herring.

Wishing you the best of health,

Martin Hum
PhD DHD Nutritionist
for Real Diabetes Truth

Bear in mind we are not addressing anyone’s personal situation and you should rely on this for informational purposes only. Please consult with your own physician before acting on any recommendations contained herein.


1. Scirica BM, Bhatt DL, Braunwald E et al. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med. 2013; 369(14):1317-1326.

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