Display options
Share it on

Diabetes Ther. 2019 Oct;10(5):1577-1593. doi: 10.1007/s13300-019-0651-1. Epub 2019 Jul 02.

Glucocrinology of Modern Sulfonylureas: Clinical Evidence and Practice-Based Opinion from an International Expert Group.

Diabetes therapy : research, treatment and education of diabetes and related disorders

Sanjay Kalra, A K Das, M P Baruah, A G Unnikrishnan, Arundhati Dasgupta, Parag Shah, Rakesh Sahay, Rishi Shukla, Sambit Das, Mangesh Tiwaskar, G Vijayakumar, Manoj Chawla, Fatimah Eliana, Ketut Suastika, Abbas Orabi, Aly Ahmed Abdul Rahim, Andrew Uloko, Silver Bahendeka, Abdurezak Ahmed Abdela, Fariduddin Mohammed, Faruque Pathan, Muhammed Hafizur Rahman, Faria Afsana, Shajada Selim, Muaz Moosa, Moosa Murad, Pradeep Krishna Shreshtha, Dina Shreshtha, Mimi Giri, Wiam Hussain, Ahmed Al-Ani, Kaushik Ramaiya, Surender Singh, Syed Abbas Raza, Than Than Aye, Chaminda Garusinghe, Dimuthu Muthukuda, Muditha Weerakkody, Shyaminda Kahandawa, Charlotte Bavuma, Sundeep Ruder, Koy Vanny, Manish Khanolkar, Leszek Czupryniak

Affiliations

  1. Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India. [email protected].
  2. Department of Endocrinology and Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India.
  3. Department of Endocrinology, Excel Hospital, Guwahati, Assam, India.
  4. Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India.
  5. Department of Endocrinology, Rudraksh Superspecialty Care, Siliguri, India.
  6. Department of Endocrinology and Diabetes, Gujarat Endocrine Centre, Ahmedabad, India.
  7. Department of Endocrinology, Osmania Medical College, Hyderabad, India.
  8. Department of Endocrinology, Regency Hospital Ltd., Kanpur, India.
  9. Department of Endocrinology, Apollo Hospitals, Bhubaneswar, India.
  10. Department of Diabetology, Shilpa Medical Research Centre, Mumbai, India.
  11. Department of Diabetology, Apollo Hospitals, Chennai, India.
  12. Department of Diabetology, Lina Diabetes Care and Mumbai Diabetes Research Centre, Mumbai, India.
  13. Department of Internal Medicine, Faculty of Medicine, YARSI University, Jakarta, Indonesia.
  14. Indonesian Association of Endocrinology, Jakarta, Indonesia.
  15. Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
  16. Department of Diabetes and Metabolism, Alexandria University, Alexandria, Egypt.
  17. Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.
  18. Department of Internal Medicine, Diabetes and Endocrinology, St. Francis Hospital, Nsambya, Kampala, Uganda.
  19. Department of Internal Medicine, Addis Ababa, Ethiopia.
  20. Department of Endocrinology of Bangabandhu Sheikh, Mujib Medical University, Dhaka, Bangladesh.
  21. Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh.
  22. Department of Endocrinology, Dhaka Medical College and Hospital, Dhaka, Bangladesh.
  23. Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
  24. Department of Internal Medicine, Indira Gandhi Memorial Hospital, Malé, Maldives.
  25. Department of Internal Medicine, Tribhuwan University Teaching Hospital, Kathmandu, Nepal.
  26. Department of Endocrinologist, Norvic International Hospital, Kathmandu, Nepal.
  27. Department of Endocrinology, Nepal Mediciti Hospital, Kathmandu, Nepal.
  28. Department of Endocrinology and Diabetes, Dr Wiam Clinic, Royal Hospital, Awali Hospital, Awali, Bahrain.
  29. Department of Internal Medicine, Hamad Hospital, Doha, Qatar.
  30. Department of Diabetology, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania.
  31. Department of Internal Medicine, Aster Al Raffah Hospital, Muscat, Oman.
  32. Department of Endocrinology, Shaukat Khanum Hospital and Research Center, Lahore, Pakistan.
  33. Myanmar Society of Endocrinology and Metabolism, Yangon, Myanmar.
  34. Department of Endocrinology, Colombo South Teaching Hospital, Colombo, Sri Lanka.
  35. Department of Endocrinology, Sri Jayawardenepura General Hospital, Sri Jayawardenepura Kotte, Sri Lanka.
  36. Department of Endocrinology, Teaching Hospital Karapitiya, Galle, Sri Lanka.
  37. Department of Endocrinology, District General Hospital, Matara, Sri Lanka.
  38. Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Rwanda.
  39. Department of Endocrinology and Metabolism, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
  40. Department of Diabetes and Endocrinology, Dr Koy Vanny Diabetes and Endocrine Clinic, Phnom Penh, Cambodia.
  41. Department of Endocrinology and Diabetes, Waikato Hospital, Hamilton, New Zealand.
  42. Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

PMID: 31267358 PMCID: PMC6778594 DOI: 10.1007/s13300-019-0651-1

Abstract

AIM: The primary objective of this document is to develop practice-based expert group opinion on certain important but less discussed endocrine and metabolic effects of modern sulfonylureas (SUs) and their usage in the management of diabetes mellitus (DM).

BACKGROUND: Modern SUs may be considered a panacea in DM care with their beneficial extra-pancreatic, pleiotropic, and cardiovascular effects. Safe glycemic control with SUs could be achieved with appropriate patient selection, drug and dosage selection, and patient empowerment. Additionally, sulfonylureas also exhibit certain endocrine and metabolic effects, which could be considered beneficial in the management of DM. In this regard, a group of international clinical experts discussed the less known beneficial aspects of SUs and safe and smart prescription of modern SUs in DM care.

RESULTS: The concept of glucocrinology or the relationship of glycemia with the endocrine system was emphasized during the meetings. Clinical experts arrived at a consensus for the usage of modern SUs in the presence of other endocrine dysfunction and the impact of these drugs on endocrine health. The beneficial pleiotropic and cardiovascular effects of modern SUs were also discussed. The key discussion points were considered to develop clinical expert opinions for the use of modern SUs in persons with DM. Clinical expert opinions were developed for indications, pleiotropic benefits, cardiovascular outcomes, adherence, and safe use of modern SUs.

CONCLUSIONS: Appropriate clinical judgement coupled with a patient-centered approach is crucial to achieve the best outcome in persons with DM. Owing to their safety, efficacy, extra-pancreatic benefits including effects on endocrine and metabolic aspects, and low cost of therapy, modern SUs could be considered as drugs/agents of choice for the treatment of diabetes.

FUNDING: Sanofi India.

Keywords: Cardiovascular complications; Cardiovascular phenotype; Extra-pancreatic effects; Glimepiride; Glucocrinology; Modern sulfonylureas; Myocardial ischemic preconditioning; Type 2 diabetes mellitus

References

  1. Diabetes Ther. 2017 Aug;8(4):863-873 - PubMed
  2. Int J Mol Sci. 2018 Sep 21;19(10): - PubMed
  3. Indian J Endocrinol Metab. 2018 Jan-Feb;22(1):132-157 - PubMed
  4. Indian J Endocrinol Metab. 2015 Sep-Oct;19(5):577-96 - PubMed
  5. Am Heart J. 2011 Oct;162(4):620-626.e1 - PubMed
  6. Acta Diabetol. 1995 Dec;32(4):273-8 - PubMed
  7. Cardiovasc Diabetol. 2014 Jun 19;13:102 - PubMed
  8. Diabetes Care. 2019 Jan;42(Suppl 1):S103-S123 - PubMed
  9. N Engl J Med. 2015 Jul 16;373(3):232-42 - PubMed
  10. Diabetes Care. 2007 Nov;30(11):2773-8 - PubMed
  11. J Med Invest. 2006 Feb;53(1-2):87-94 - PubMed
  12. Metabolism. 2009 Feb;58(2):143-8 - PubMed
  13. Circulation. 2001 Jun 26;103(25):3111-6 - PubMed
  14. Curr Pharm Des. 2009;15(27):3179-92 - PubMed
  15. J Pak Med Assoc. 2016 Apr;66(4):480-2 - PubMed
  16. Stroke. 2017 Feb;48(2):388-393 - PubMed
  17. Diabetes Care. 2010 Jun;33(6):1224-9 - PubMed
  18. Diabetes Care. 2009 Dec;32(12):2143-8 - PubMed
  19. Circulation. 2017 Oct 24;136(17):1643-1658 - PubMed
  20. Diabetes Res Clin Pract. 2017 Oct;132:169-170 - PubMed
  21. Curr Neuropharmacol. 2015;13(3):389-94 - PubMed
  22. Lancet Diabetes Endocrinol. 2015 Jan;3(1):43-51 - PubMed
  23. Ann Intern Med. 2018 Sep 18;169(6):394-397 - PubMed
  24. Card Fail Rev. 2017 Apr;3(1):52-55 - PubMed
  25. N Engl J Med. 2013 Oct 3;369(14):1317-26 - PubMed
  26. Diabetes Res Clin Pract. 2005 Jun;68(3):250-7 - PubMed
  27. PLoS One. 2014 Feb 12;9(2):e82880 - PubMed
  28. Circulation. 2018 Jul 31;138(5):458-468 - PubMed
  29. Vasc Health Risk Manag. 2012;8:463-72 - PubMed
  30. J Clin Endocrinol Metab. 2003 Feb;88(2):531-7 - PubMed
  31. Lancet. 1998 Sep 12;352(9131):854-65 - PubMed
  32. Ochsner J. 2014 Winter;14(4):616-32 - PubMed
  33. Int J Cardiol. 2013 Jun 20;166(2):404-12 - PubMed
  34. PLoS Med. 2016 Apr 12;13(4):e1001992 - PubMed
  35. J Clin Endocrinol Metab. 2010 Nov;95(11):4993-5002 - PubMed
  36. JAMA. 2019 Jan 1;321(1):69-79 - PubMed
  37. Diabetes Care. 2002 Jan;25(1):107-12 - PubMed
  38. Value Health. 2008 Jan-Feb;11(1):44-7 - PubMed
  39. N Engl J Med. 2013 Apr 25;368(17):1613-24 - PubMed
  40. Med Care. 2009 Aug;47(8):826-34 - PubMed
  41. Cardiovasc Diabetol. 2014 Aug 10;13:123 - PubMed
  42. J Diabetes Complications. 2017 Jul;31(7):1215-1221 - PubMed
  43. Diabetes Care. 2003 Jul;26(7):2215-6 - PubMed
  44. J Pak Med Assoc. 2018 Jun;68(6):963-965 - PubMed
  45. Adv Ther. 2014 Dec;31(12):1287-305 - PubMed
  46. Diabetes Care. 2017 Nov;40(11):1469-1478 - PubMed
  47. Metabolism. 2006 May;55(5 Suppl 1):S20-7 - PubMed
  48. Arch Intern Med. 2006 Sep 25;166(17):1836-41 - PubMed
  49. N Engl J Med. 2008 Jun 12;358(24):2560-72 - PubMed

Publication Types

Grant support