Sulfonylurea, an Update / 임상당뇨병

ABSTRACT

Sulfonylureas (SUs) are widely prescribed in the treatment of type 2 diabetes. Despite the availability of several newer agents, SUs still play an important role in glucose-lowering therapy. However, over the last decade, there is a degrowth of older agents (SUs and thiazolidinediones) prescriptions with emergence of newer agents such as dipeptidyl peptidase-4 inhibitors, sodium glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists. The role of SUs in modern clinical practice poses ongoing clinical debate. With active marketing of these newer drugs, the concerns regarding hypoglycemia, secondary failure and cardiovascular safety tend to be overstated, especially when considering SUs. Some evidence has suggested that modern SUs (such as gliclazide modified release and glimepiride) have lower hypoglycemia and secondary failure rates and decreased risk of mortality from all-cause and cardiovascular disease compared to conventional SUs in patients with type 2 diabetes. Appropriate clinical judgement coupled with a patient-centered approach is crucial to achieve the best outcome in patients with type 2 diabetes. Modern SUs should also be considered based on their safety, efficacy, and low cost when choosing anti-hyperglycemic agents.