The role of sulfonylureas in the treatment of type 2 diabetes

Brian Tomlinson, Nivritti Gajanan Patil, Manson Fok, Paul Chan, Christopher Wai Kei Lam

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Type 2 diabetes (T2D) is increasingly prevalent and associated with increased risk for cardiovascular and renal disease. After lifestyle modification, metformin is usually the first-line pharmacotherapy and sulfonylureas are traditionally added after metformin failure. However, with newer glucose lowering drugs that may have less risk of hypoglycemia or that may reduce cardiovascular and renal events, the position of sulfonylureas is being reevaluated. Areas covered: In this article, the authors review relevant publications related to the use of sulfonylureas. Expert opinion: Sulfonylureas are potent glucose lowering drugs. The risk of hypoglycemia varies with different drugs within the class and can be minimized by using the safer drugs, possibly in lower doses. Cardiovascular events do not appear to be increased with some of the newer generation drugs. The durability of glycemic control also appears comparable to other newer agents. Sulfonylureas are the preferred treatment for some types of monogenic diabetes and selection of T2D patients who may have greater benefit from sulfonylureas based on certain phenotypes and genotypes is likely to be refined further by precision medicine. Sulfonylureas are inexpensive and readily available everywhere and they are still the most frequently used second-line treatment for T2D in many parts of the world.

Original languageEnglish
Pages (from-to)387-403
Number of pages17
JournalExpert Opinion on Pharmacotherapy
Volume23
Issue number3
DOIs
Publication statusPublished - 2022

Keywords

  • Cardiovascular events
  • gliclazide
  • glimepiride
  • glipizide
  • glycemic durability
  • hypoglycemia
  • sulfonylureas
  • type 2 diabetes

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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