Do sulfonylureas still have a role in blood sugar and diabetes control?
At present, there are a large number of pharmacological agents available for good control of blood sugar and effectively treat type 2 diabetes (T2D).The task of making a choice for the optimal drug for any given patient a complex task. Since newer agents offer several advantages, whether and when sulfonylureas (SUs) should still be used to treat T2D is controversial.
Expert Opinion from a European Consensus Panel to be published in the journal Diabetes Obesity Metabolism has laid down treatment guidelines and recommendations that should govern the general approach to diabetes management and optimum blood sugar and glycemic control. Although current joint EU/US guidelines address overall type 2 diabetes (T2D) management, this present European consensus paper aims to provide additional guidance on the use of sulfonylureas in T2D.
The experts summarize current local treatment guidelines in European countries, showing that sulfonylureas are still widely proposed as second-line treatment after metformin and often ranked at the same level as newer blood-sugar-lowering medications. Although, the newer agents confer greater benefits they are more costly.
Key recommendations
1. After metformin, for second-line glucose-lowering medication, sodium-glucose cotransporter-2 inhibitors (SGLT-2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), or to a lesser extent, dipeptidyl peptidase-4 inhibitors (DPP-4is) are preferred over sulfonylureas because of minimal hypoglycemic risk.
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