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Sulfonylureas: A New Look at Old Therapy

  • Pharmacologic Treatment of Type 2 Diabetes (A Vella, Section Editor)
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Abstract

Sulfonylurea compounds were the first available oral antidiabetic agents and they remain an important tool in our quest for optimal glucose control. The sulfonylureas stimulate the release of insulin from pancreatic β-cells and have a number of extrapancreatic effects, including decreasing hepatic insulin clearance and reducing glucagon secretion in patients with type 2 diabetes. Although these agents have been the mainstay of pharmacotherapy for patients with type 2 diabetes mellitus (T2DM), their safety and clinical utility has been a matter of active debate in recent years, as their use is associated with risks of hypoglycemia and weight gain. We review the discovery and mechanisms of action of sulfonylureas, and the results of clinical trials to provide practical information on the pros and cons of their use in clinical practice. This review addresses advances in our understanding of mechanisms of action of sulfonylurea agents, their efficacy in T2DM, side effects, and impact on cardiovascular disease outcomes.

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Acknowledgments

Peter M. Thulé is supported in part by a VA Merit Award, JDRF Research Grant, and JDRF Innovative Award. Guillermo Umpierrez is supported in part by research grants from the American Diabetes Association (7-03-CR-35) and PHS Grant UL1-RR-025008 from the Clinical and Translational Science Award program, National Institutes of Health, National Center for Research Resources.

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Conflict of Interest

Peter M. Thulé declares that he has no conflict of interest. Guillermo Umpierrez has received grant support for investigator-initiated studies from Merck, Sanofi, Boehringer Ingelheim, and Novo Nordisk.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Section Endocrinology and Metabolism, Atlanta VA Medical Center, Atlanta, GA, USA

    Peter M. Thulé

  2. Division of Endocrinology, Diabetes, and Lipids, Department of Medicine, Emory University School of Medicine, Decatur, GA, 30033, USA

    Peter M. Thulé & Guillermo Umpierrez

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  1. Peter M. Thulé
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  2. Guillermo Umpierrez
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Correspondence to Guillermo Umpierrez.

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This article is part of the Topical Collection on Pharmacologic Treatment of Type 2 Diabetes

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Thulé, P.M., Umpierrez, G. Sulfonylureas: A New Look at Old Therapy. Curr Diab Rep 14, 473 (2014). https://doi.org/10.1007/s11892-014-0473-5

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