State of the art paper Sulfonylureas and their use in clinical practice
Open accessAbstract
Many anti-diabetic drugs with different mechanisms of action are now available for treatment of type 2 diabetes mellitus. Sulfonylureas have been extensively used for treatment of type 2 diabetes for nearly 50 years and, even in our times, are widely used for treatment of this devastating chronic illness. Here, we review some of the available data on sulfonylureas, evaluating their mechanism of action and their effects on glycemic control. We can conclude that sulfonylureas are still the most used anti-diabetic agents: maybe this is due to their lower cost, to the possibility of mono-dosing and to the presence of an association with metformin in the same tablet. However, sulfonylureas, especially the older ones, are linked to a greater prevalence of hypoglycemia, and cardiovascular risk; newer prolonged-release preparations of sulfonylureas are undoubtedly safer, mainly due to reducing hypoglycemia, and for this reason should be preferred.
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Sulfonylureas are frequently used as second-line medications for patients with type 2 diabetes mellitus who are not extremely obese.
“People with T2DM who are not extremely obese are frequently treated with second-line medications known as sulfonylureas.”
From A critical review on diabetes mellitus type 1 and type 2 management approaches: from lifestyle modification to current and novel targets and therapeutic agents. (2024) · cites this paper as [56]
The Introduction says sulfonylureas should be considered for patients who are not overweight, and the Conclusions say they are frequently used and can be added when metformin does not achieve adequate control. The paper does not specifically say they are frequently used as second-line treatment in the broader group of patients who are ‘not extremely obese’; it also describes other reasons to use them. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSulfonylureas act by directly obstructing ATP-sensitive K+ channels on islet cells, which increases the generation of insulin.
“Their mechanism action is by directly obstructing ATP-sensitive K+ channels on islet cells, which increases the generation of insulin.”
From A critical review on diabetes mellitus type 1 and type 2 management approaches: from lifestyle modification to current and novel targets and therapeutic agents. (2024) · cites this paper as [56]
The Mechanism of action section says sulfonylureas block potassium flow through ATP-dependent channels on pancreatic β-cells, triggering insulin secretion. It supports increased insulin release, but not the claim that this mechanism increases insulin generation. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSulfonylureas are insulin secretagogues that enhance the quantity of insulin produced by pancreatic β-cells, thereby reducing plasma glucose levels.
“Sulfonylureas are secretagogues of insulin that enhance the quantity of insulin produced by pancreatic β-cells, therefore reducing plasma glucose levels (56–58).”
Sulfonylureas' primary acute side effect is a higher incidence of hypoglycemia, particularly in elderly patients with impaired renal function, hepatic dysfunction, poor oral intake, calorie restriction, alcohol abuse, and other disorders.
“Sulfonylureas’ primary acute side effect, is a higher incidence of hypoglycemia, particularly in elderly patients with impaired renal function, hepatic dysfunction, poor oral intake, calorie restriction, alcohol abuse, and other disorders (56, 59).”
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- Authors
- Sola, D., Rossi, L., Schianca, G. P. C., Maffioli, P., Bigliocca, M., Mella, R., Corlianò, F., Fra, G. P., Bartoli, E., & Derosa, G.
- Affiliations
- Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT)
- Azienda Ospedaliero Universitaria Maggiore della Carita (IT)
- University of Pavia (IT)
- Corresponding author
- Rossi, Luca
- Venue
- Archives of Medical Science
- Publisher
- Termedia Sp. z.o.o.
- Published
- 2015
- Volume
- 4
- Issue
- 4
- Pages
- 840-848
- ISSN
- 1734-1922 (ISSN-L)
- PMC
- PMC4548036
- OpenAlex
- W2407625702
- Cited by
- 514
- References
- 5
- Citations by year
- 2026: 26 · 2025: 43 · 2024: 71 · 2023: 60 · 2022: 75 · 2021: 74 · 2020: 48 · 2019: 50 · 2018: 38 · 2017: 25 · 2016: 3 · 2014: 1
- FWCI
- 19.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Archives of Medical Science (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- 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 › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- sulfonylureas, type 2 diabetes, antidiabetic drugs, mechanism of action, glycemic control, hypoglycemia, cardiovascular risk, sustained-release formulation, metformin combination therapy, drug costs
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