Grant: CIHR New Investigator

Treatment of type 2 diabetes often requires the use of several oral drugs. Overall, these drugs help to lower blood sugars levels and reduce the risk of kidney, eye, and nerve damage. Differences appear to exist, however, with respect to the effect of each drug's on the risk of cardiovascular disease (i.e., heart and stroke disease). For example, previous research has suggested that metformin may reduce the risk of cardiovascular disease, while newer agents such as the thiazolidinediones may in fact increase the risk. Given the wide spread use of newer drugs in the treatment of diabetes, better evaluation of the cardiovascular effects of these agents is required. The range of drugs available to treat diabetes in Canada has recently expanded with the approval of a new oral antidiabetic drug - sitagliptin. These drugs are rapidly being used to control blood sugars in patients with diabetes, yet there effects on heart disease and stroke are not known. This study will measure the risk of heart disease and stroke in people using sitagliptin relative to other drugs, like metformin or glyburide. Information from this study will help clinicians better determine which combination of drugs is safe and effective for the treatment of type 2 diabetes.