Intermittent Fasting vs. Sulfonylureas: Heart Attack Outcomes

This article is Round 3 of Intermittent Fasting (I.F.) vs. Sulfonylureas

Recap: Round 1 went to I.F. because it protects and renews the cells that produce insulin. Sulfonylureas try to squeeze insulin out of burned out insulin cells.

Round 2 also went to I.F. as it resolves the hidden high insulin levels of type 2 diabetes. In contrast, sulfonylureas make insulin levels higher and continue the complications of diabetes.

Diabetics are prone to heart attacks. This article will present who is better at protecting the heart of diabetics. Intermittent fasting or sulfonylureas.

Intermittent Fasting Lowers the Risk of Heart Disease

Intermittent fasting lowers the heart attack risk as it reduces blood sugar, increases fat burning, improves the lipid profile, and lowers blood pressure.

Intermittent Fasting Improves the Durability of the Heart

For those who are on an eat-all-you-can diet, the heart attack size is bigger. In contrast, intermittent fasting conditions the heart muscles. If ever a heart attack happens, the size of dead tissue in the heart is smaller and has fewer complications.

That cannot be said for the popular class of diabetic medication called sulfonylureas.

Patients on Sulfonylureas Do Worse after a Heart Attack

Examples of sulfonylureas are glyburide, glipizide, and gliclazide. The reason why they produce worse outcomes after a heart attack is that sulfonylureas diminish the blood flow to the heart.

Several institutions have warned against sulfonylureas namely:

The National Diabetes Center in 2000, has warned against the use of higher sulfonylurea doses because it increases cardiovascular mortality.

A 2017 study published in the Journal of the American Heart Association concluded: (boldface mine)

Predominantly male patients initiating treatment for diabetes mellitus with sulfonylurea had a higher risk of heart failure and cardiovascular death compared to similar patients initiating metformin

and finally the U.S. Food and Drug Administration in an April 1, 2019 report said that:

(b) Labeling for oral hypoglycemic drugs of the sulfonylurea class shall include in boldface type at the beginning of the “Warnings” section of the labeling the following statement:

Special Warning on Increased Risk of Cardiovascular Mortality

The administration of oral hypoglycemic drugs has been reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin.

1024px-Muhammad_Ali_fights_Brian_London_on_August_6,_1966 — Muhammad Ali Delivered a Knock-out Punch to Brian London in the 3rd Round in 1966

There you have it. Intermittent fasting is superior in many aspects to sulfonylureas in type 2 diabetes.

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References:

Christopher F Toombs, Teresa L Moore, Ronald J Shebuski, Limitation of infarct size in the rabbit by ischaemic preconditioning is reversible with glibenclamide, Cardiovascular Research, Volume 27, Issue 4, April 1993, Pages 617–622, https://doi.org/10.1093/cvr/27.4.617
Rahmi Garcia, Rosa Maria, et al. “Impact of hypoglycemic agents on myocardial ischemic preconditioning.” World journal of diabetes vol. 5,3 (2014): 258-66. doi:10.4239/wjd.v5.i3.258
Roumie et al., Comparative Safety of Sulfonylurea and Metformin Monotherapy on the Risk of Heart Failure: A Cohort Study. Originally published19 Apr 2017https://doi.org/10.1161/JAHA.116.005379Journal of the American Heart Association. ;6:e005379

Image Credit:

Muhamad Ali By PA – Action Images, Public Domain, https://commons.wikimedia.org/w/index.php?curid=62430280

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