Consensus Recommendations on Sulfonylurea and Sulfonylurea Combinations in the Management of Type 2 Diabetes Mellitus - International Task Force

Sanjay Kalra 1, Silver Bahendeka 2, Rakesh Sahay 3, Sujoy Ghosh 4, Fariduddin Md 5, Abbas Orabi 6, Kaushik Ramaiya 7, Sameer Al Shammari 8, Dina Shrestha 9, Khalid Shaikh 10, Sachitha Abhayaratna 11, Pradeep K Shrestha 12, Aravinthan Mahalingam 13, Mazen Askheta 14, Aly Ahmed A Rahim 15, Fatimah Eliana 16, Hari K Shrestha 17, Sandeep Chaudhary 18, Nancy Ngugi 19, Jean Claude Mbanya 20, Than Than Aye 21, Tint Swe Latt 22, Zhanay A Akanov 23, Abbas Raza Syed 24, Nikhil Tandon 25, A G Unnikrishnan 26, S V Madhu 27, Ali Jawa 28, Subhankar Chowdhury 4, Sarita Bajaj 29, Ashok Kumar Das 30

Affiliations

01 January 2018

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doi: 10.4103/ijem.IJEM_556_17

Abstract

For decades, sulfonylureas (SUs) have been important drugs in the antidiabetic therapeutic armamentarium. They have been used as monotherapy as well as combination therapy. Focus on newer drugs and concerns about the risk of severe hypoglycemia and weight gain with some SUs have led to discussion on their safety and utility. It has to be borne in mind that the adverse events associated with SUs should not be ascribed to the whole class, as many modern SUs, such as glimepiride and gliclazide modified release, are associated with better safety profiles. Furthermore, individualization of treatment, using SUs in combination with other drugs, backed with careful monitoring and patient education, ensures maximum benefits with minimal side effects. The current guidelines, developed by experts from Africa, Asia, and the Middle East, promote the safe and smart use of SUs in combination with other glucose-lowering drugs.

Keywords: Gliclazide; glimepiride; sulfonylureas; type 2 diabetes.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1 Mechanism of action of sulfonylureas. (a) General mechanism of action of all sulfonylureas. (b) Differential mechanism of action of gliclazide

Figure 1 Mechanism of action of sulfonylureas. (a) General mechanism of action of all sulfonylureas. (b) Differential mechanism of action of gliclazide

Figure 2 Complementary mechanism of action of sulfonylurea-metformin combination therapy

Figure 2 Complementary mechanism of action of sulfonylurea-metformin combination therapy

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