Title:Efficacy and Cardiovascular Safety of Sulfonylureas
Volume: 16
Issue: 2
Author(s): Cornelius James Fernandez*, Arkiath Veettil Raveendran and Nyi Htwe
Affiliation:
- Department of Endocrinology and Metabolism, Pilgrim Hospital, Boston, PE21 9QS,United Kingdom
Keywords:
Sulfonylureas, diabetes mellitus, cardiovascular safety, efficacy, cardiovascular safety, hyperglycemia.
Abstract: There is a universal agreement that when lifestyle modifications are inadequate to control
the hyperglycemia, metformin should be considered the first line of pharmacological therapy.
However, when metformin monotherapy fails, there is no consensus as to which drug should be
added. Many new classes of drugs that are currently available including DPP-4 inhibitors, GLP-1
agonists and SGLT-2 inhibitors have undergone cardiovascular outcome trials which had been
made mandatory by the regulatory authority and thereby established their cardiovascular safety or
at least neutrality. Though sulfonylureas are one of the widely prescribed drugs both in developed
and developing countries and have proven their efficacy for glycemic control and prevention of microvascular
complications, there is considerable uncertainty about its cardiovascular safety which
has been going on for nearly five decades. In this review, we will critically analyze the efficacy
and cardiovascular safety of sulphonylureas, based on the latest available literature to clarify their
role in our day-to-day clinical practice.
