Sulfonylureas in NIDDM
Abstract
Sulfonylureas have represented the backbone of oral therapy in non-insulin-dependent diabetes mellitus for > 30 yr. Despite this, our knowledge about the mode of actions of these agents is limited, and the use of them is far from rational. Sulfonylureas lower blood glucose concentrations primarily by stimulating insulin secretion. The evidence for clinically significant extrapancreatic effects is scanty. Therefore, the effect of sulfonylurea is limited to patients with preserved β-cell function, with the best effect observed in the early stages of the disease. Sulfonylurea treatment is often started relatively late and is continued when the agents can no longer achieve the treatment goals. Drug dosages are increased to maximum recommended doses, although there is no evidence for a dose-response relationship between the sulfonylurea dose and its biological effect. To rationalize the use of sulfonylureas, we should ask the questions to whom, how much, and for how long? The decision to stop treatment is as important as the decision to start treatment.
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Sulfonylureas appear to be similar to metformin in efficacy, lowering A1C levels by approximately 1.5 percentage points.
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- Authors
- Groop, L. C.
- Affiliations
- Helsinki University Hospital (FI)
- Corresponding author
- Groop, Leif C
- ORCID
- Groop, Leif C
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1992-06-01
- Volume
- 15
- Issue
- 6
- Pages
- 737-754
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1989058656
- Cited by
- 408
- References
- 0
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2022: 4 · 2021: 1 · 2020: 6 · 2019: 6 · 2018: 4 · 2017: 6 · 2016: 9 · 2015: 7 · 2014: 21 · 2013: 12 · 2012: 16
- FWCI
- 11.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- sulfonylureas, type 2 diabetes, oral antidiabetic therapy, insulin secretion, beta-cell function, drug dosing, treatment duration, treatment discontinuation
- MeSH terms
- Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Islets of Langerhans, Sulfonylurea Compounds
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