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Panminerva Medica 2013 September;55(3):239-51

language: English

Sulfonylureas and meglitinides: historical and contemporary issues

Lamos E. L., Stein S. A., Davis S. N.

Endocrinology, Diabetes and Nutrition, Medicine, University of Maryland School of Medicine, Baltimore, MD, USA


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Insulin secretagogue therapy is commonly used in clinical practice. These agents may be utilized as first, second-line or adjunct therapy behind metformin for treatment of type 2 diabetes mellitus. Sulfonylureas and meglitinides are effective treatments, but cumulative data over decades of research raise concerns regarding universal prescribing. The role of insulin secretagogue therapy in β-cell failure, blunting of ischemic pre-conditioning, the incidence of hypoglycemia – specifically in at-risk populations, modest weight gain and the unproven link to cancer are discussed. Ultimately, many of the concerns appear to be agent and not class-specific with glibenclamide fairing the worst amongst all of the agents discussed.

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sdavis@medicine.umaryland.edu